Community Investment Eligibility Questionnaire

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Community Investment Eligibility Questionnaire

Focus Areas(Required)

Which focus area(s) does your program fit within? Check all that apply.

Health Access

Economic Mobility

Educational Equity

Poverty Reduction

Other

Guidelines

Check all that apply. *The Chattahoochee Valley includes any of the following counties: Chattahoochee, Clay, Harris, Marion, Muscogee, Quitman, Stewart, Taylor, and Talbot Counties in Georgia and Russell County in Alabama.

Yes – this program serves the people of the Chattahoochee Valley*

Yes – we want to apply for general operating or programmatic funds (not for a capital campaign or endowment)

Yes – our organization is a public charity, organized under IRS Sec. 501 (c)(3)

We are NOT seeking funding for

Check all that apply.

An individual

A fundraiser or sponsorship, one-time event, or dinner

A startup organization

Name(Required)

First Last

Organization(Required)

Email(Required)

Phone(Required)

Phone

This field is for validation purposes and should be left unchanged.

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1005 Front Avenue Columbus, GA 31901
PO Box 1157 Columbus, GA 31902
706-327-3255 (Phone) 678-619-0387 (Fax)
EWELLS@UNITEDCV.ORG (EMAIL)

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