Application for Federation Application General InformationArea of specific focus or current organization nameName of main contact person First Last Contact Person TitleAddress Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country PhoneEmail Website If applicable, name of Executive Director and Chair of the Board:SignatureHow did you learn of this opportunity? Referral Organization Website Social Media Current Member of In Word and Witness Email Campaign Other ProposalProvide one comprehensive report that includes all the following information. Upload to the form application.General Requirements Provide one comprehensive report that includes all the following information. Upload to the form application. Proposal Narrative Each of these areas must be addressed in a total of 6-10 pages. Mission/Purpose of your Organization. How is your mission/purpose aligned with the mission and core values of In Word and Witness? - Introduction page. 1 page maximum. Comprehensive report Concise overview of your organization’s history, mission, leadership structure, staffing, and programs, including the target population and activity. What is unique in your approach and how this will enhance the approach of In Word and Witness? List 3-5 goals and objectives for this partnership and give specific measurable criteria and timeline for successful completion of any specific future action in light of this partnership. Expected long-term impact of this work on In Word and Witness, and/or the fields of evangelization and catechesis. Proposed itemized program budget with supportive narrative. Download and use the provided template for budget and corresponding logic model assessment. A narrative should compliment this template. ProposalAdditional AttachmentsPlease include the requested documents, if applicable, as additional attachments. Current copy of 501(c)3 IRS non-profit letter, or equivalent proof of non-profit status. List of board members/leadership team, how often the board/leadership team meets. If minutes are kept, please include the last 3 meeting minutes. By-laws or other organizational operational guidelines. Two letters of support. Additional Files Drop files here or Financial AttachmentsPlease include the requested documents, if applicable, as additional attachments. Current 990 filed with IRS (including schedule B). If not required to file, then submit narrative as to why. Most recent audit with management letter. If you do not have an audit please explain board’s expertise and procedures to ensure solid financial standing. Current year’s operating budget with revenues and expenses. Previous year’s budget versus actual revenue and expenses. Financial Files Drop files here or SubmissionElectronic submission is required. These should be uploaded as one comprehensive pdf document. Application deadline is September 1. Approval will be notified by mail/email by the month of November.