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First Name
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Email
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What is your organization's current legal entity status?
Registered 501(c)(3) Non-profit
Limited Cooperative Association (LCA) or Cooperative Corporation
Benefit Corporation (B-Corp) or L3C
LLC / For-Profit Small Business
Individual / Unincorporated Group
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Do you have a formal fiscal sponsor that holds active 501(c)(3) status?
No
Yes
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Where is your organization primarily registered and operating? (State/Territory)
What is the primary focus area of your organization's mission?
Healthcare Access, Pharmacy Innovation, or Wellness Support
Cooperative Economics, Community Wealth Building, or Mutual Aid
Agriculture, Food Security, or Sustainability
Education, Technology, or Research
If you checked Cooperative Economics or Mutual Aid: Does your initiative utilize a worker-owned, patient-owned, or community-governed operational framework?
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What was your organization's total operating budget for the last complete fiscal year?
Under $50,000
$50,000 – $250,000
$250,000 – $1 Million
Over $1 Million
SelectRoughly how many employees are currently on your baseline payroll?
1 – 5 employees (Mostly volunteer or founder-led baseline)
6 – 20 employees
21 – 100 employees
101+ employees
Has your organization successfully managed or received any formal grants in the past 3 years?
Yes
No
Please list up to 3 of your most recent grant achievements (Funder Name, Operational Purpose, and Award Amount):
Which service interests you the most?
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Curated Profile Match
Do It For Me
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