Giving Application Disclosure I have read the BCU Charitable Giving Guidelines and believe that my organization’s request meets their requirements. Please review the BCU Charitable Giving Guidelines and then check the box to submit this request. *All Information is required for your application to be given consideration. Organization Information Organization Full Name* Organization Full Name must be populated to submit this request. Executive Director / Leader Name* Organization Executive Director/ Leader Name must be populated to submit this request. Street Address1* Street Address1 must be populated to submit this request. Street Address2 City* City field must be populated to submit this request. State* -- Please Select -- Alabama Alaska Arizona Arkansas California Colorado Connecticut District of Columbia Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming State field must be populated to submit this request. Zip* Postal Code field must be in one of the following numeric formats: xxxxx or xxxxx-xxxx. Organization Phone Number* Organization Telephone Number is required and must be in the format of xxxxxxxxxx or xxx-xxx-xxxx to perform this update. Organization Email* Organization Email address required and must be in the format xxx@yyy.zzz Organization Tax I.D./501c3 documentation* Organization Tax I.D. must be populated to submit this request Organization Web Address REQUIRED: Please describe your organization’s history, mission and key focus (100 words or less).* OPTIONAL: You may forward additional information, such as promotional brochures or marketing materials, by attaching to a separate email and sending to: CharitableGiving@BCU.org The Organization history, mission and key focus description of 100 words or less is required. Please enter the names and affiliated organizations of your Board of Directors.* REQUIRED: Please provide a copy of the organization’s most recent, audited financial statement. Please send the statement as an attachment to an email, and send the email to: CharitableGiving@BCU.org. Thank you.* Primary Contact Information (Individual Completing This Application) Primary Contact Prefix Primary Contact First Name* Primary Contact First Name must be populated to submit this request. Primary Contact Last Name* Primary Contact Last Name must be populated to submit this request. Primary Contact Title Primary Contact Phone Number* Primary Contact Telephone Number is required and must be in the format of xxxxxxxxxx or xxx-xxx-xxxx to perform this update. Primary Contact Email Address* Primary Contact Email address required and must be in the format xxx@yyy.zzz Donation Request Information Donation Request Amount* (please do not include a decimal and cents) Please enter a valid Amount (from $1 up to $99,999 only) for Donation Request. Project Title / Event Name (20 words or less)* A Project or Event Name of 20 words or less is required. Please describe the Project/Event and how a donation from BCU would be used (250 words or less)* A Project Description of 250 words or less is required. Total project / event budget* (please do not include a decimal and cents) Please enter a valid Amount for Project Budget. Please provide the percentage of your budget used for direct services to clients, the community, etc. Please enter a valid value for Percentage of funds. Names of any BCU employees, volunteers or Directors involved with your organization Submit
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