HandsOn Northwest North Carolina

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Building Up Initiatives and Leadership Diversity (BUILD) Application

Fields marked with an asterisk (*) are required.

Executive Director First Name

Executive Director Last Name

Executive Director Phone Number

How long have you served as the ED of this nonprofit?

Nonprofit name as listed on 501(c)3

Work Email

EIN (Employer Identification Number)

Nonprofit Mailing Address

Mailing Street

Mailing City

Mailing State

Mailing Zip

Nonprofit website address, if applicable

Number of years this nonprofit has been in operation

Nonprofit's approximate budget (enter amount without commas)

USD

Nonprofit Overview- Provide a few sentences (no more than a paragraph) to answer each of the following questions

What is the mission of your nonprofit?

What programs/services does your nonprofit provide?

Describe the constituents your organization serves

(for example, demographics, is there a specific neighborhood or community being served, does the nonprofit primarily serve communities of color/minority groups)

What are your current challenges as an Executive Director and as an organization?

How do you believe the technical/leadership/organizational training and financial support provided through BUILD will help you and your nonprofit succeed?

Certifications and agreement

I certify that the above information is true and that this nonprofit: (must check all boxes) *

Is a designated 501(c)3 as defined by the Internal Revenue Code

Is located in and/or serving Forsyth County residents

Is led by a person of color and serves a majority of people of color/minority groups

Has a total annual operating budget equal to or less that $250,000

This field is required

As the Executive Director of this nonprofit, I agree to (must check all boxes) *

The requirements to participate in BUILD (attend 80% of all meetings, develop an action plan for stipend expenses that is approved by HandsOn NWNC, complete all training evaluations, and provide the required reporting information to evaluate the overall effectiveness and impact of this program)

Use the program activity stipend in accordance with the guidelines outlined in the document "Capacity Building Activities"

This field is required

Section

I grant full permission to HandsOn NWNC and its representatives/organizers, to use photographs of and quotations from me without compensation for marketing, promotion, and Web content in print and/or electronically. Signature of Executive Director

Date

Submit

Building Up Initiatives and Leadership Diversity (BUILD) Application

Nonprofit Mailing Address

Nonprofit Overview- Provide a few sentences (no more than a paragraph) to answer each of the following questions

Certifications and agreement

CONNECT WITH US!

NEWSLETTER

Common Messages

Building Up Initiatives and Leadership Diversity (BUILD) Application

Nonprofit Mailing Address

Nonprofit Overview- Provide a few sentences (no more than a paragraph) to answer each of the following questions

Certifications and agreement

CONNECT WITH US!

NEWSLETTER

Get Social with Us!

Common Messages