Client Intake Form

Primary point of contact at your organization *

First Name

Last Name

Phone *

(###)

###

####

Secondary point of contact at your organization *

First Name

Last Name

Phone *

(###)

###

####

Business mailing address *

Where you would receive grant award checks and other communications

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Are you registered as a Charitable Organization with either your state's Secretary of State or Attorney General? *

Yes

No

If so, are your annual registration renewal and fees up to date? *

Yes

No

If you've been established for more than one fiscal year have you filed a 990 or 990N E-Postcard every year? *

Yes

No

Do you have a recent financial audit (within the last 3 years)? *

Yes

No

Have you applied for grants in the past? *

Yes

No

Attachments to send

IRS tax determination letter Certificate of incorporation List of current board of directors with bios and affiliations List of current staff with full names, titles, bios and/or resumes Most recent financial statement and/or audit A spreadsheet of your organizational budget List of grant awards (grantmaker, amount, and project, if applicable) from the past year, if available List of board contributions (financial and in-kind) from the previous year Most recent annual report, if available Most recent strategic plan, if available Last fiscal year’s 990

I agree to send the above attachments to info@sparkgroupconsulting.com