"Every Idea That Comes Through our Doors is a Diamond in the Rough" "Every Idea That Comes Through our Doors is a Diamond in the Rough"
Polish Inc.
Ezekiel & Ruth D. Lowe Senior's Foundation
Post Office Box 680821
Charlotte, NC 28216-0030
Workshop Intake Form
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Date Deposit $ Full Organization Name Organization Address City VT AK AL AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY County Name of Contact Address of Contact Organization Telephone of Contact Organization Email of Contact Zip Code Tax ID# If yes, need copy of EIN Letter Year ends in what month? January Febuary March April May June July August September October November December Is organization Inc.? Yes No Date If yes, Need copy Is the Organization part of a larger organization? Yes No Is the organization a church? Yes No a daycare? Yes No a school? Yes No Does the organization have bylaws? Yes No If yes, Need copy Can the organization provide the following? (Check all that apply) List of active Board of Directors Copy of written bylaws Budgets (last three years if available) Copy of deed or lease agreement Brochure, flyer, programs of the organization List/ brochure of programs Source of all funds List of fund raising activities Other (explain) Provide Additional Information or Question
Full Organization
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Is the Organization
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Questions or problems regarding this web site should be directed to Black Rose Designs, Inc. Copyright © 2004 [Polish Inc.]. All rights reserved. Last modified: 12/08/07.