Tell Us About Your Organization

Name of Organization: *

Name(s) of Principal(s): *

Complete Title(s) of Principal(s):

Contact Information

Address 1:

Address 2:

City:

Zip:

Phone:

Fax:

Email:

Website:

Name of Program or Project (if different from organization):

Geographic Location:

Focus of Program or Project:

Demographic Overview of Focus Community or Population

People With Disabilities:

People With Disabilities (if "Other"):

Ethnicity:

Ethnicity (if "Other"):

Income Level (HUD Definition):

Rural:

Rural

Urban:

Urban

Age Ranges:

Language:

Gender:

Education:

Description of Focus Areas

Goals:

Accessibility - How do you address accessibility today?:

Objectives:

Strategies:

Outcomes:

Organization History

Date Program/Project Launched:

Date Founded:

Size and Magnitude of Program or Project

Range of Number of People Served:

Range of Number of Staff/Volunteers Involved:

Range of Number of Impacted:

Annual Budget:

Staff:

Percentage of total Funding

Enter the percent of Total Funding from each of the sources

% Government:

% Board of Directors:

% Corporations:

% Foundations:

% Individuals:

% Earned income:

% Reserves:

Results and Evidence of Success

Metrics for Evaluation Progress:

What is your rate of success on an annual basis - i.e., workforce training, how many secured gainful employment?

Changes in Outcomes or Metrics Over Time:

How long does it take to secure results for the program above?:

Note: By submitting the Organization Profile you agree that the:

Your Organization expressly grants permission to post the submitted information in a public area of the CETF website,
Statements and represenations made about your non-profit site are true and do not contain falsehoods;
Your Organization will keep the information updated either on its own or at the prompting of CETF to ensure that it remains true and accurately reflects the current status and historical operating results of your organization.

You also give CETF the right to share the information with its Board, officers, employees and agents in printed documents as the Fund seeks to share examples.