Join the Fight
RFP Process Survey
Butler County United Way Request for Funding Survey
Is your agency 501(c)3 designated?
Yes
No
We do not accept requests for funding from agencies without a 501(c)3 certification.
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Legal Name of Organization:
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Agency Address:
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Employer Identification Number (EIN#):
Are you located in Butler County and/or provide a program that serves Butler County?
Yes
No
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What is your program name?
Is this a single program or collaborative?
Program (Your agency is the only provider)
Collaborative (Your agency is partnering with other agencies to provide programming)
What other agencies are you partnering with in the collaboration?
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Butler County United Way is program-focused to see measured impact and evidence of a successful program. Do you offer a program that is focused on education (ex. early childhood literacy, after school program, prevention, etc.), health (ex. counseling, medical, rehabilitation, etc.) and/or financial stability (utility assistance, housing assistance, food insecurity, etc.)?
Yes
No
N/A
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Please explain:
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What will Butler County United Way funding be used for to make your program successful?
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Do you seek funding support from other sustainable resources in order to ensure a successful program?
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Name of Executive Director:
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Executive Director Phone Number:
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Executive Director Email Address:
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Name of person completing this survey:
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Contact Phone Number:
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Contact Email Address:
Items marked with an asterisk(*) are required
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