Membership Eligibility Process Application Instructions. General Instructions: Please Read All Instructions First!

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1 Membership Eligibility Process Application Instructions General Instructions: Please Read All Instructions First! 1. Contact United Way Member Services Team for assistance with this application. We can be reached by: Phone: , Option 1 Fax: The eligibility application opens at 9:00 am on November 2, The application closes at 5:00 pm on December 2, No applications will be accepted after this time. Applications left incomplete or not submitted will be deemed ineligible. 3. Access the application at The application must be submitted online. Please contact United Way Member Services for assistance if you are unable to submit any part of the application. 4. United Way NCA Member Services representatives (permanent and temporary) will be available between November 2 nd and December 2 nd to assist you. If you have any technical issues, please contact our Member Services Team at the address or phone number listed above. 5. Returning applicants are sent their seven-digit Secret Key and log in instructions by in the last week of October. If you have not received this information, please contact United Way NCA Member Services Team by phone or . You will need this code along with your organization s EIN number in order to access the 2016 membership application. 6. Interested nonprofit applicants should contact us by phone ( , Option 1) or by You will need to provide the legal name of your organization and the Employer Identification Number (EIN) in order to receive further instructions. You may be required to provide a one page description of your programmatic activities and a copy of your organization s most recently completed IRS Form You will need the following items in order to complete your online application: a. Program information for your organization: program names, regions served, numbers of beneficiaries and specific program activities (including dates) for calendar year 2015.

2 b. Most recent IRS Determination Letter. c. A copy of your organization s non-discrimination policy. d. Most recently completed IRS Form 990 (year ending June 30, 2014 or later) or a pro forma IRS Form 990. e. Most recently completed audited financial statements (if greater than $100,000 in revenue) for the same year as the 990. f. If applicable, any trade name or DBA certificates for your organization. g. Chapters, affiliates, or organizations covered by a group ruling will need to submit additional documentation (see instructions). 8. The online application consists of seven sections or tabs. These sections do not need to be completed in order, but you must click save on each tab as you finish working in that tab. You will not be able to submit your application until all required fields have been completed. 9. Complete all required fields in the online application. Required fields are indicated by an asterisk (*). Please enter the requested information fully and completely in each field. 10. Save often. If you time out of the application, you will lose unsaved information. You will time out of the application after 60 minutes of inactivity. 11. After typing your name in the online application, you will be able to click on a link and generate a PDF copy of your organization s signature page. Your authorized representative will need to sign in blue or black ink and mail TWO (2) signed copies of the certification page (do not fax) to: United Way of the National Capital Area Attn: Member Services 1577 Spring Hill Road, Suite 420 Vienna, VA Your application is not considered complete until it has been submitted online and we receive the two original signature pages. 12. Once your nonprofit has submitted its application by the deadline, you will be notified of any missing or incomplete information in your application by one of our temporary Member Services staff. Your organization will have the opportunity to provide the required information and resubmit its application. If deficiencies in your organization s application are not resolved by the given deadline, your organization s application will be deemed ineligible. 13. Organizations will be notified of their approval or denial for membership by January 8, Organizations whose applications are deemed ineligible will be notified immediately and will be encouraged to apply to the Combined Federal Campaign as independent organizations if they so choose. 2

3 3 Step-by-Step Application Instructions Accessing Your Application Create An Account The first time you visit you must create an account. Click sign up for an account and enter the following: First Name Last Name Telephone Number - use format (xxx)xxx-xxxx Valid Address - this will be your username Password (of your choice, must be at least 6 characters and contain a number and a letter) EIN for Your Organization - use format xx-xxxxxxx Secret Key contact Member Services if you do not know it Once you click Create you will then be redirected to login with your address and password. If you represent more than one organization applying for membership: You can associate multiple organizations with your account. Click on My Account at the top of the screen and enter the EIN and Secret Key for each additional organization. You will be redirected to login again in order to complete the addition. Step 1: Member Information United Way NCA Designation Code - This information will be pre-filled for returning applicants. This is the designation code assigned to your organization in the campaign. New applicants will have a blank field. If you are accepted as a member nonprofit for the campaign, a United Way NCA designation code will be assigned to you. If you believe that the information in this field is incorrect, please contact customer service for assistance. CFC Designation Code - This information will be pre-filled for returning applicants. This is the CFC designation code assigned to your organization for the 2015 CFC campaign. CFC codes are assigned by the Office of Personnel Management and generally do not change from year to year. If you think the number in your application is incorrect, please contact customer service for assistance. Federation - This information will be pre-filled for returning applicants. If your organization is not a member of another federation (i.e. Local Independent

4 4 Charities of America), the field will show United Way. If you believe this information is incorrect, please contact member services for assistance. *Legal Name of Organization This field cannot be changed. The legal name of your organization is the same as that on your IRS tax determination letter. If you believe the information in this field is incorrect, please contact member services for assistance. If the legal name has changed, you must provide us with proof of the name change. Preferred Name If your organization uses a name other than the legal name, please enter it here. Type of Preferred Name Please choose the option that best describes the preferred name entered above. This question is only required if you entered a preferred name. United Way NCA is often required to list an organization by the legal name unless official documentation is provided. a. An officially registered doing business as (DBA) or trade name. Select this option if your organization has filed paperwork with your state or county of incorporation in order to use a name other than your legal name. Please also upload a copy of the official state documentation authorizing use of the dba name. Different states have different terms for this. In Virginia it is known as a fictitious or assumed name certificate. In Maryland and the District of Columbia it is a trade name. b. An unofficial name by which donors know your organization. Choose this if the preferred name you provided is not an officially registered name. DBA or Trade Name Certificate This item is required only if your organization listed a preferred name and indicated it is an officially registered DBA (selected A above). Please click the Browse button and select the file to be uploaded. Enter the year of the document (i.e. 2007) and click save. *Employer Identification Number (EIN) - Enter this 9-digit number using the following format: *Main Organization Telephone - Provide the telephone number for general inquiries to your nonprofit; enter the number as (xxx)xxx-xxxx with no spaces. Organization TDD/TTY If your organization has a telecommunications number for the deaf or hard of hearing, please enter it here in this format (xxx)xxx-xxxx. Organization Website - Provide your organization s Website, all addresses should be full and complete; do not include http prefixes. If your organization does not have a website, leave this field blank.

5 5 *General Organization Address - Provide the address for general inquiries to your agency. *Date of Incorporation - Provide the date of incorporation for your agency; format as mm/dd/yyyy. State of Incorporation choose the state where your organization is incorporated. *Days/ Hours of Operation - Include both days and hours. Examples: Monday - Friday, 9 am - 5 pm; Daily, 9 am - 5 pm; Monday, Tuesday, Wednesday, 9 am - 5 pm. Total Number of Employees Please enter the number of employees your organization has in the national capital area (may be full or half time staff). Full time volunteers should be counted as employees. Total Number of Board Members Please enter the number of persons who served as board members in your organization for Total Number of Volunteers Please enter the number of persons who served as volunteers for your organization in Please do not count persons already included as employees or board members above. Total Beneficiaries Served Annually For each REGION, please provide the total unduplicated number of persons served by your organization in For each, enter the percentage of those served who would be classified as having household incomes LESS THAN 50% of Area Median Income (AMI). In the Washington Metro Area, 50% of AMI is $35,001 per year. Estimates are acceptable of this section. *Physical Address - Complete all physical address information. The address entered should be the official physical (business) address. P.O. Boxes are not permitted unless the nature of your organization's work presents legitimate security concerns for your employees, clients, and/or other stakeholders. In these cases, you must attest to the presence of such concerns as well as provide an explanation of your safety concerns. If using a P.O. Box in this section, check the yes box to be able to certify that a Post Office Box is being used for security reasons and provide an explanation of your specific security concerns (for example, your organization is a domestic abuse shelter and for the safety of your clients and staff, it is not safe to release the organization s address). Service Address If your organization s physical address is outside of the National Capital Area (i.e. not located in the District of Columbia; Montgomery or Prince George s Counties in Maryland; or Alexandria, Arlington, Fairfax/Falls Church, Loudoun, or Prince William Counties in Virginia) please provide the local service address. Otherwise, leave this field blank.

6 Mailing Address - The address entered should be the (business) mailing address for your organization. P.O. Boxes are permitted. If this address is the same as the physical address, please click the Same Address button. 6 Step 2: Contacts *Primary Representative - Provide name and contact information for the main representative authorized to act on behalf of your agency. This will be the official contact for United Way business. *CEO/Executive Director/President - Provide name and contact information for your organization s principal officer. If this person is the same as the primary representative, click the Same as Primary button and the contact information from above will be transferred. Grants Representative - Please enter contact information for the person responsible for Community Impacts Grants information. Volunteer Coordinator - Please enter contact information for the person responsible for volunteer recruitment and coordination. If this person is the same as the primary representative, click the Same as Primary button and the contact information from above will be transferred. Representative for Marketing and/or Communications - This person may be contacted regarding promotional materials, success stories, cooperative advertising opportunities, and ensuring adherence to co-branding requirements. If this person is the same as the primary representative, click the Same as Primary button and the contact information from above will be transferred. Representative for Fundraising and/or Resource Development - Please enter contact information for the person in your organization that has primary responsibility for your fundraising and/or resource development efforts. This person will also be the contact to coordinate your organization s in-house United Way employee giving campaign. If this person is the same as the primary representative, click the Same as Primary button and the contact information from above will be transferred. Step 3: Program Information Tell us about your organization s programs and services. The information provided in this section will be used to show the substantive local services,

7 benefits, assistance or program activities provided by your organization during the calendar year Please review the example in the application, complete the required fields and click Save Program for each program you wish to list. Program Name, Region(s) Served, Type and Number of Beneficiaries You will be asked to provide the information for each program entered and saved. Populations Served is not required. You may only enter up to 10 programs. Program Description Please briefly describe in no more than three sentences the actual services, benefits, assistance or program activities that this program provided in calendar year 2015, and describe how they affect the human health and welfare of the target population (1000 characters maximum). Please refer to the example on the application. If you include activities provided by another entity, such as an affiliate or a grantee, you must describe your organization s role in the activity (i.e. funding, donated space, etc.). We have listed some additional tips and recommendations below. DO: Be specific about recurring activities. DO: Avoid repetitive text and generalized statements about the activity. DO: List only services or activities that were actually provided, not those planned or offered. DO: List grants or funding provided to other organizations, but be careful to describe your organization s role as a grantor, not the provider of the service. DON T: Claim dissemination of information or publications by mail or internet as the only services or benefits provided. DON T: Claim fundraising activities as services or benefits. DON T: Include website content, information about your organization s mission or history, or personal quotes and storylines. Specific Dates of Service This information will allow us to show that the services were provided during calendar year Please be specific about dates or recurrences of programs. Examples: Daily from June 15, 2015 through August 15, 2015 Weekdays, January 2015 December 2015 Mondays to Fridays, January 2015 December 2015 Every Tuesday and Thursday afternoon from Jan 2015 May 2015 and Sept 2015 Dec 2015 Second Monday of every month, January December 2015 April 22, 2015 at Fairfax Public Library and September 3, 2015 at DC Public Library School Examples: Program runs from September 2015 through April 2016 during the school year, every Tuesday 7

8 8 Every Monday to Friday during the academic year (January 3, June 7, 2015; September 5, 2015 to December 21, 2015). Step 4: Required Documents * IRS Letter of Determination - Please upload your organization s most recent Letter of Determination, as provided by the IRS, granting your organization taxexempt status under 26 U.S.C. 501(c)3. The IRS letter must indicate the EIN for the organization. Note: Applicants whose current 501(c)3 status cannot be confirmed by the IRS will be denied participation. We encourage organizations to request current letters from the IRS confirming their tax-exempt status, especially if the name or address has changed since the most recent letter was issued. The request can be made by contacting the IRS at , and selecting Option 4. Select only one option regarding your organization s tax exempt status. Choice (a): Your organization is not part of a group exemption. Choice (b): Local organizations that are part of an IRS group exemption must provide their group number and upload a copy of the IRS letter granting the group exemption (it must have the 4 digit group number). They will need to provide the name and EIN of the parent/national organization. They must also provide and upload the current list of subordinates that are covered by the group exemption. The EIN on the applicant s Form 990 must match the EIN on the current list of subordinates. (For organizations covered under a church ruling, we will accept a photocopy of the church s most recently published listing of your organization, i.e. the 2015 Official Catholic Directory.) Choice (c): Bona-fide chapters or affiliates of a national organization that do not have an IRS determination letter for the local organization must provide and upload a certification letter signed by either the Chief Executive Officer (CEO) or CEO equivalent of the national organization, dated on or after October 1, Such certification must state that the local charitable organization operates as a bona-fide chapter or affiliate in good standing of the national organization and is covered by the national organization s 501(c)3 tax exemption, IRS Form 990 and audited financial statements, to the extent required by regulation. The certification letter needs to be on national parent s letterhead and must include the complete local address and phone number for the chapter or affiliate. A copy of the national organization s 501(c)3 letter must be uploaded as well. You may for a sample letter.

9 * IRS Form Upload a copy of the most recently completed, signed and dated IRS Form 990 covering the fiscal period ending not more than 18 months prior to January 1, 2016 (i.e. on or after June 30, 2014). Note: The IRS Form 990 must be signed in the block marked 'signature of officer.' The preparer's signature alone is not sufficient. Organizations that file the IRS Form 990 electronically may submit a signed copy of the IRS Form EO or IRS Form 8453-EO in lieu of a signature on the IRS Form 990. A completed IRS Form 990 is required to be eligible for CFC and United Way of the National Capital Area campaigns even if the Internal Revenue Service does not require your organization to file the Form 990. The IRS Form 990 and the audit (if applicable) must cover the same period. Smaller organizations, those with annual revenue of less than $250,000, may submit a proforma IRS Form If you filed a complete IRS Form 990 to the IRS, please include all applicable supplemental statements and schedules for the applicant organization. If you filed an IRS Form 990 EZ or 990N, please complete a proforma IRS Form 990. See below for what is required when submitting a proforma IRS Form 990. If you were not required to file an IRS Form 990, you must submit a proforma IRS Form 990. See below for what is required when submitting a proforma IRS Form 990. If your organization is a chapter or affiliate organization and you do not file a 990, you must complete a proforma IRS Form 990 including information specific to your chapter or affiliate. Proforma 990 Instructions - The organization must use the 2013 or 2014 IRS Form 990. The following sections must be completed: Page 1, Lines A-M, Part I (Summary) lines 1 4 only; Part II, Signature Block; pages 7 and 8, Part VII, Compensation section A only; page 9, Part VIII, Statement of Revenues; page 10, Part IX, Statement of Functional Expenses; and page 12, Part XI, Financial Statements and Reporting. The IRS Form 990 can be downloaded from the IRS web site at Note: United Way NCA will compare the number of voting members disclosed in Part I, Line 3 with the number of individuals that have the individual trustee or director or institutional trustee position selected in Part VII, Column C. If the number in Part 1 is more than the number in Part VII, the organization must provide a signed explanation for the difference on its letterhead. Select Only one option regarding your organization s IRS Form 990. If your organization submits a full IRS Form 990 plus schedules to the IRS, select option A. If your organization submits a 990EZ, 990N, or is not required to file at all, select option B.

10 10 Enter the requested information using the most recent IRS Form 990 or proforma 990. Do not use a 990 EZ or 990 N to complete this section. Please follow the instructions on the screen to determine which numbers to use from your organization s 990. Overhead Percentage is calculated by adding the amount in Part IX (Statement of Functional Expenses), Line 25, Column C (Management and General Expenses) to the amount in Line 25, Column D (Fundraising Expenses), and dividing the sum by Part VIII (Statement of Revenue), Line 12, Column A (Total Revenue). No other methods may be used to calculate this percentage. Audited Financial Statement - If your organization s annual revenue as stated on the IRS Form 990 is $100,000 or greater, provide an audit for your charitable organization covering the fiscal year ending not more than 18 months prior to January 1, 2016 (i.e. on or after June 30, 2014). Note: The audit must express an unqualified opinion, must be conducted by an independent Certified Public Accountant in accordance with Generally Accepted Auditing Standards (GAAS), and Generally Accepted Accounting Principles (GAAP). Cash basis, cash modified, or modified accrual basis accounting systems are unacceptable. Reviews and/or compiled audits are unacceptable. Bona-fide chapters or local affiliates of a national organization that are not separately incorporated whose pro forma IRS Form 990 reports revenues over $100,000 and whose financial operations are covered by an audit of the national organization may submit the national organization s audited financial statements together with a certification from the national organization s Chief Executive Officer (CEO) or CEO equivalent stating that it operates as a bona-fide affiliate in good standing of the national organization s tax exemption, IRS Form 990 and audited financial statements (see the letter of determination section above). The audit (if applicable) must cover the same period as the IRS Form 990. If you submitted an audit, please input your Total Revenues and Total Expenses in the appropriate boxes. * Non-Discrimination Policy - You are required to provide and upload a copy of an approved non-discrimination policy, signed by an officer of your organization, and must be identifiable to your organization (using letterhead or another indicator). The policy must comply with the following certification: Have a policy and demonstrate a practice of non-discrimination as it relates to the operation of the organization, including service delivery, on the basis of race, creed, color, religion, gender, age, national origin, physical or mental health, sexual orientation or any characteristic protected by law.

11 11 Step 5: Impact Areas * 25 Word Description - Describe your charitable organization in 25 words or less (no need to repeat the name of your organization within the 25 words). The statement will appear in campaign materials. Please note that this may be the only information provided to a potential donor about your organization. Special design text used to draw attention to an organization title, such as special fonts, capitalization, quotations, and underlines, are not accepted. Hyphenated words count as two. Extended Statement You may enter a statement of up to 200 words to further describe your organization s programs and mission. This statement should be ready for use on web sites or other campaign materials. Program Service Categories - Select the program service categories best representative of your organization s program(s). Main categories include: Education, Health, Financial Stability, Basic Needs, and Other. CFC Taxonomy Codes - Use the drop down menu to select up to 3 codes that best fit your organization s services. CFC donors can search on these codes to find organizations working in specific areas. You must enter at least one code. Step 6: Certifications Part I These certifications are aligned with our membership criteria and are required for participation in the United Way of the National Capital Area and other federation campaigns. Check all appropriate boxes. * Human Health and Welfare Organization Status - Check the box to certify. * Tax Exempt Status Check the box to certify. * Active Board of Directors - Check the box to certify. * Contributor Lists Check the box to certify. * Use of Funds Contributed - Check the box to certify. * Publicity and Promotional Activities Check the box to certify. * Terrorist Exclusion - Check the box to certify. * Substantial local presence in the CFCNCA - Check the box to certify.

12 12 Step 7: Certifications Part II These certifications are aligned with our membership criteria and are required for participation in the United Way of the National Capital Area and other federation campaigns. Check all appropriate boxes. * Legal Structure - Check the box to certify. * Local Presence and Services - Check the box to certify. * Non-Discrimination Policy - Check the box to certify. * Support of the United Way Campaign - Check the box to certify. * Workplace Campaigns - Check the box to certify. * Disbursement of Designations and Campaign Fees - Check the box to certify. Federation Representation - Check the box to certify (not required). * Certification Statement - Please review the certification statement and check the box to certify that your organization understands that United Way of the National Capital Area (NCA) will submit an application to the Combined Federal Campaign (CFC) of the National Capital Area and Commonwealth of Virginia Campaign (when appropriate) on your organization s behalf. Your organization should not apply independently to any of these campaigns or ask another federation to apply to these campaigns unless United Way NCA notifies your organization that it has deemed its application ineligible to be submitted as part of United Way NCA s application packages to the above campaigns. Sign and Submit Once you have completed all required fields in the application, you will finalize the application process by clicking on the Sign and Submit tab. * Authorized Signature - Read carefully and type your name in the box. Typing your name certifies that you are the duly appointed representative of the organization named in your application. You are authorized to certify and affirm all statements enclosed in the application. You certify that you have read all the certifications set forth in the document and affirm their accuracy. After typing and saving your signature in the online application, you will be able to click on a link and generate a PDF copy of your organization s signature page. Your authorized representative will be able to sign in blue or black ink and mail us TWO (2) signed copies of the certification page. If any required fields remain incomplete on a previous section, the name of the section will be listed in red above the Submit button. You must go back to the listed section and complete it before being able to submit the application. The submit button will not be accessible until all required fields have been completed.

13 13 * Submitting Your Application - In order to submit your application for review you must click the Submit button. If you do not submit your application to United Way NCA, it will not be reviewed by our staff. Upon submitting your application, it will become read-only. You will be able to log in, but you will not be able to make any changes. After Submitting Your Application After submitting your application, you will receive an with a PDF copy of your signature page (the link to the PDF will also be accessible in the Sign and Submit tab before you submit the application). You MUST print and send TWO (2) signed copies of the certification page (do not fax) to: United Way of the National Capital Area Attn: Member Services 1577 Spring Hill Road, Suite 420 Vienna, VA Your application is NOT considered complete until it has been submitted online and we receive the two (2) original, signed certification pages. Please sign in ink (blue or black ink preferred) and do not provide photocopies.

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