The Good News
HERALD
Application for Networking
Contact Information
Organization Name
Contact Name
Street Address
City State Zip
Cell Phone
Work Phone
Fax
E-Mail Address
Web Site Address
Services Provided
What type of services does your organization provide?
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
About your organization
Tell us briefly about what your organization is about and what kind of organization it is.
Example : 501(c)(3), Faith based organization
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
Staff Positions Titles & Responsibilities
Names
______________________________________ ___________________________________
______________________________________ ___________________________________
______________________________________ ___________________________________
______________________________________ ___________________________________
Organizational Successes
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
Organizational Needs
______________________________________________________________________________
______________________________________________________________________________
Optional:
Funding Source Budget
¬Individuals %______________ * Salaries %____________________________
¬Grants % __________________ * Operational Expenses %_________________
¬Endowments % ________________ * Services Provided %____________________
¬Other %____________ * Other %_____________________________
¬Total ________________ * Total ________________________________
Who’s on your board of directors
President ______________________ 9. ______________________________
Vise President ______________________ 10. ______________________________
Treasurer _________________________ 11. ______________________________
Secretary _______________________ 12. ______________________________
6. __________________________ 13. ______________________________
7. __________________________ 14. ______________________________
8. __________________________ 15. ______________________________
References
1. ________________________________________________
2. ________________________________________________
3. ________________________________________________
Agreement and Signature
By submitting this application, I affirm that the facts set forth in it are true and complete. I understand that if our organization and or individuals are accepted, any false statements, omissions, or other misrepresentations made by our organization and or individuals on this application may result in your immediate removal from the web page.
Name (printed)
Signature
Date
Fax to: (831) 484-6059
Mail to: The Good News Herald
PO Box 7711
Spreckels, CA 93962
Thank you for your application