WMF letter of inquiry

Please be as concise as possible

Submissions each year are due by June 1.

Organization

1. Name of organization *This question is required.

2. Name of fiscal agent (if applicable)

3. Organizational budget *This question is required.

4. 501(3)(c) status? *This question is required.

5. Contact information

Principal contact *This question is required.

Title *This question is required.

Street Address *This question is required.

Apt/Suite/Office

City *This question is required.

State *This question is required.

Zip *This question is required.

Telephone *This question is required.

Email *This question is required.

6. Please provide brief description of organization, its mission, and programs *This question is required.

7. Grant history with WMF (include years applied and years funded) *This question is required.

Request

8. Name of specific program for which funding is sought (or indicate general operating funds) *This question is required.

9. Is the program located within 30 miles of a Wellington office? *This question is required.

10. Economic eligibility *This question is required.

Are at least 70% of participants in the program economically disadvantaged? (200% of federal poverty guidelines or lower) *This question is required.

How is that determined? (brief) *This question is required.

11. Clearly describe the program (not just your mission statement) focusing on what a typical day looks like *This question is required.

12. When was the program established?

13. What age group does the program serve? *This question is required.

14. How many participants are served by the program? *This question is required.

15. How many hours a week do participants attend the program? *This question is required.

16. How many weeks a year do participants attend the program? *This question is required.

17. Is attendance mandatory? *This question is required.

18. What are the goals of the program? *This question is required.

19. Are you able to track the long-term success of participants? *This question is required.

20. How do you define and measure participant success? *This question is required.

21. Total cost of the program *This question is required.

22. Total cost per child *This question is required.

23. Names of any Wellington Management advocates

Contact person for this application

First Name *This question is required.

Last Name *This question is required.

Title *This question is required.

Organization *This question is required.

Address line 1 *This question is required.

Address line 2

Town/City *This question is required.

Post code *This question is required.

Email Address *This question is required. This question requires a valid email address.

Phone Number *This question is required.

Contact person for this application

First Name *This question is required.

Last Name *This question is required.

Title *This question is required.

Organization *This question is required.

Street Address *This question is required.

Apt/Suite/Office

City *This question is required.

State *This question is required.

Zip *This question is required.

Email Address *This question is required. This question requires a valid email address.

Phone Number *This question is required.