Sponsorship Request

Eligibility screening

Questions	Yes	No
Does your organization serve residents of Racine County, WI?	Yes	No
Is your organization tax exempt as described in section 501(c)(3) of the Internal Revenue Code?	Yes	No
Is your organization able to provide detailed financial reports and board-approved budgets, if requested?	Yes	No
Does your organization maintain policies of non-discrimination, equal opportunity and comply with the Americans Disability Act?	Yes	No

Sponsorship Request

Organization legal name

Organization EIN #

Organization name as you'd like it to appear in United Way materials/reports

Organization website address

Organization telephone number

Address

Address 2

City/Town

State

ZIP/Postal Code

Organization executive director/president/CEO

Name

Title

Phone

Board president/board chair

Name

Phone

Primary contact for this request

Name

Title

Phone

Is there any additional information you would like to share?

Terms

I agree to the funding terms of service.

I agree to the funding terms listed.

I am authorized to submit this request on behalf of my organization.
The information provided is complete and accurate to the best of my knowledge.
If my organization is currently funded by UWRC via any other fund, I certify that my organization is in compliance with all policies and procedures at the time of submitting this request. This includes, but is not limited to, governance documents and demographic/impact reports.
Requests that meet funding guidelines are not guaranteed funding.
UWRC reserves the right to change the focus of the fund at any time.
Sponsorship funds are available until money is exhausted.

I agree to send our organization's required documents

Please immediately respond to the confirmation email to submit your organization's proof of IRS determination of 501(c)3 status (required) and any supplementary documents related to sponsorship benefits and/or event/project details (optional). Failure to do so within two business days will result in the disqualification of your request.

*If your project or program has been funded through United Way of Racine in the past twelve (12) months, we do not need another copy of your 501(c)3 unless changes have been made. *

I hereby certify on behalf of the organization named in this application that all United Way funds and donations will be used in compliance with all applicable anti-terrorist financing and asset control laws, statues, and executive orders.

Name and Title:

Donate

Sponsorship Request

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