100 Women Who Care North Suburban Chicago
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Chicago Trib Article 2-12-23
Charity Pre-Qualification Form for Charities
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Indicates required field
Name of Organization
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Name of Contact Person
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First
Last
Email of Contact Person
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Web URL
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Please provide your 501(c)(3) Tax ID number below
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Please list the date the organization became recognized as a 501(c)(3)
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What % of your funds are allocated to providing services in Lake or Cook County, EXCLUDING the city of Chicago?
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0%
1-25%
26-50%
51%-75%
76%-100%
Which of these BEST describes how your funding is dispersed? (choose only one)
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Distributed to other charities or direct service groups
Direct service delivery for our charity
If you receive an award are you willing to send a representative to our next meeting to share how the money was, or will be, spent?
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YES
NO
Do you agree NOT to create, sell or distribute a list with our members' contact information?
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YES
NO
Do you agree NOT to solicit our members directly for further contributions?
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YES
NO
Will you grant us your permission to publish content from your publications or Facebook page onto our Facebook page?
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YES
NO
Submit