top of page
GET FUNDED COHORT – ORGANIZATION INTAKE FORM
SECTION 1: Organization Snapshot
First name
*
Last name
*
Email
*
Phone
*
Organization Name
*
EIN (or Fiscal Sponsor – Yes/No)
*
Year Founded
*
Address
*
Website
SECTION 2: Operating Budget
Current Annual Operating Budget
*
Under $50,000
$50,000–$249,999
$250,000–$999,999
$1M–$5M
$5M+
Primary Revenue Sources (check all that apply)
*
Grants
Government contracts
Donations
Earned income
Corporate sponsorships
SECTION 3: Stage of Development
Which best describes your organization?
*
Idea / Pre-launch
Newly formed (0–12 months)
Early operations (1–3 years)
Established (3+ years)
Scaling / Expansion
Check all that apply:
*
501(c)(3) approved
Active Board of Directors
Financial statements prepared
Strategic plan in place
Prior funding received
SECTION 4: Focus Area
Primary Focus Area (select up to 2):
*
Workforce Development
Youth / Justice-Involved Youth
Education / STEM
Affordable Housing
Small Business / Entrepreneurship
Financial Literacy
Health / Mental Health
Faith-Based / Community Development
Arts & Culture
Reentry / Second Chance
SECTION 5: Populations & Demographics Served
Age Groups Served
*
Youth (12–17)
Young Adults (18–24)
Adults (25–54)
Seniors (55+)
Populations Served (check all that apply)
*
Economically impacted
Justice-involved
Black / African American
Latino / Hispanic
Immigrant / Refugee
Single-parent households
Women-led households
Veterans
Estimated Individuals Served Annually
*
Under 100
100–499
500–999
1,000+
SECTION 6: Geographic Reach, ZIP Codes & LMI
Primary ZIP codes served
*
Service Area
*
Neighborhood
City
County
State
Multi-state
National
Do you primarily serve Low-to-Moderate Income (LMI) communities?
*
Yes
No
Not sure
How do you determine LMI status? (check all)
*
Census tract / HUD data
Household income under 80% AMI
Free/reduced lunch eligibility
Program eligibility requirements
Geographic service area
Not currently tracked
Estimated % of participants who are LMI
*
Under 25%
25–49%
50–74%
75%+
SECTION 7: Length of Time Doing the Work
How long have you been actively doing this work?
*
Less than 1 year
1–3 years
3–5 years
5–10 years
10+ years
Is this an expansion of prior informal/grassroots/ministry work?
*
Yes
No
If yes, briefly explain (1–2 sentences).
SECTION 8: Funding Goals & Needs
Funding sought in the next 12 months
*
$5K–$25K
$25K–$100K
$100K–$500K
$500K+
Funding Types of Interest
*
Bank CRA grants
Corporate sponsorships
Foundations
Government contracts
Program-related investments
Loans / lines of credit
Biggest challenges (select up to 2)
*
Not fund-ready
Don’t know where to apply
Weak financials
No bank relationships
Capacity / staffing
Messaging & pitch
SECTION 9: Banking Relationships
Primary bank
*
Chase
Wells Fargo
Bank of America
Capital One
PNC
U.S. Bank
Truist
Community bank (name)
Credit union (name)
Other
Do you have a relationship manager?
*
Yes
No
Have you ever received funding from a bank?
*
Yes
No
If yes, what's the name of the bank and how much?
SECTION 10: Cohort Commitment
Why do you want to join Get Funded?
*
Are you able to attend live sessions?
*
Yes
No
Are you prepared to submit documents if requested?
*
Yes
No
SECTION 11: Permissions & Next Steps
Open to bank/funder introductions?
*
Yes
No
Open to site visits or showcases?
*
Yes
No
Interested in ongoing support after cohort?
*
Yes
No
Submit
bottom of page