January 27, 2016 steve APPLY General Information: This application is designed to provide us with enough information about an organization and its plans to determine if it is eligible for fiscal sponsorship. Additional information and communications may be necessary. Please fill out all of the requested information.How did you hear about Mission.Earth? *Google Searchfiscalsponsordirectory.orgfiscalsponsor.netOtherOther: Please specify: Basic Information:Today's Date: *Organization Name: *If you do not have an "organization" please fill in a project name or title for mutual reference.Contact Name: *Phone: Email: *Website: If you have a website, please provide the url.Mailing Address: *We will need a physical address for verification purposes.Street AddressApt, Suite, Bldg. (optional)CityState / Province / RegionPostal / Zip CodeAfghanistanAlbaniaAlgeriaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCentral African RepublicChadChileChinaColombiaComorosCongo (Brazzaville)CongoCosta RicaCote d\'IvoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast Timor (Timor Timur)EcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFijiFinlandFranceGabonGambia, TheGeorgiaGermanyGhanaGreeceGrenadaGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiKorea, NorthKorea, SouthKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorwayOmanPakistanPalestinian TerritoryPalauPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint VincentSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited States of AmericaUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamWestern SaharaWestern SamoaYemenZambiaZimbabweCountryType of Organization: *CorporationLimited Liability CompanyUnincorporated AssociationTrustPartnershipNeighborhood GroupIndividualOtherOther: If you chose "Other," please specify: Mission and Plans:What is your organization's or project's mission and vision? *Describe all the ways that your project contributes to the public good: *Describe your project in as much detail as possible, including how you will accomplish your mission and what activities you, your staff and/or your volunteers will engage in. *Does the organization or project intend to engage in any lobbying activity or influence elections? *YesNoWhat geographical area does your project intend to cover? *What categories best describe your projects work? *Addiction TreatmentArts and CultureChildren, Youth & FamiliesDisaster ReliefEconomic DevelopmentEducationEnvironmentFaith BasedFestivals & EventsHealth & NutritionHousingInternational DevelopmentMental HealthPeople or Communities of Color / MinoritiesPolitical AdvocacySocialSocial / Human ServicesSocial JusticeTransportationWomenYouth DevelopmentOtherWhat is your project's budget (projected): *This amount is what you hope or expect to raise over the next twelve months.$0 - $10,000$10,000 - $25,000$25,000 - $50,000$50,000 - $75,000$75,000 - $150,000$150,000 - $250,000$250,000 - $500,000$500,000 - $1,000,000Over $1,000,000Does the organization have a 3-year business plan? If yes, please attach a copy. *YesNoHuh?Upload Business Plan: Does the organization have a budget projection for the next three (3) years? If yes, please attach a copy. *YesNoWhat's that?Upload 3-year Budget: Has your organization secured any financing yet or has it applied for any grants? *YesNoI wish!If yes, please provide details: History:Have you had a fiscal sponsor before for this project? *YesNoHas your organization or project applied for tax exempt status? *YesNoHow many full-time paid employees do you have? *How many paid part-time employees do you have? *How many volunteers do you have? *Does the organization or project have a bank account? *YesNoDoes your organization or project have an Employer Identification Number? *YesNoIf yes, please enter your EIN: Uploads:If available, please provide the following documents: Articles of Organization: List of Officers and Board Members: Annual Financial Report: Other: Authentication and Compliance: We are not a financial institution but we do enter into a financial contractual arrangement with our partners. In the spirit of compliance with the customer identification and verification requirements under Section 326 of the USA PATRIOT Act May 9, 2003, we require that you provide a copy of your state identification (driver's license) or your passort.Are you able to provide a copy of your driver's license or passport? *YesNoIf you answered no, please provide a reason: Passport or Driver's License Upload: Compliance Statement: By clicking "I Agree" below, you are representing and warranting that the information you have provided in this application is true and accurate to the best of your knowledge and belief. *I AgreeAPPLICATION FEE: WAIVED AT THIS TIME. VerificationPlease enter any two digits *Example: 12This box is for spam protection - please leave it blank:
