Fiscal Sponsorship Application | Open Media Foundation

The Responsible Entity is (select one) *

An individual
A partnership
A non-profit corporation
A Limited Liability Company

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Name of Responsible Individual

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Primary Contact Name

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Address

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Phone

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Fax

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Project Name

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Approximate length of project (if applicable)

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Brief Project Description

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Mission for Proposed Project

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Specific measurable objectives project will achieve

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Strategies for achieving these objectives

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Proposed timeline detailing how you will progressively advance your cause. Completed Stages

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Summary of your qualifications and a biography or resume of experience

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Describe the community your project will serve. Include a description of the demographic and geographic community(ies) you hope

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If successful, what benefits will your project bring within two years to those you hope to serve?

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Describe the work you have done to research, design, test or demonstrate the projects viability

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Describe key relationships you currently have with helpful allies in your target community(ies) and elsewhere.

How will these relationships help you achieve your project’s goals? Describe ways you interact with these people, groups and organizations with which they are affiliated. What other people, groups and organizations do you need to know or work with in order to craft a successful project?

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List the names, addresses, phone numbers, emails and community affiliations of the project’s advisory group.

And/or the people you propose to approach to become members of the advisory board. Please include a brief summary of their present and/or future contributions to your project. Please clearly identify which advisors have committed to serving on the board, and those you plan to approach

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Outline your specific expectations regarding the benefit(s) a relationship with OMF will provide your project

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Please list the names and complete contact information for your references. Be sure to indicate your relationship with each ref

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Please give us an idea of who you plan to approach for support.

It is important to communicate the general idea of your fundraising strategy and targets.

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Prospective sources of fundraising

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Create and submit a preliminary budget for your project

We understand that no budget or plan is perfect and no one can precisely predict the future. Think of your budget as a tool to identify the financial transactions needed to reach the goals you have set. If you haven’t created a budget before, we can transmit a template to help. The idea is to be as complete and thoughtful as you can. We’re just trying to get an idea of the potential scope of your overall project, and how we may best customize our services to support your mission.

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You Agree All Information is Accurate *

I acknowledge I will be required to provide a signature during the interview/review which comes later in the process

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