Communities where Broadcom communities are located:

Communities where Broadcom communities are located: Irvine, California (Corporate Headquarters) Andover, Massachusetts - Brickstone Square Andover, Massachusetts - Federal Street Austin, Texas Bellevue, Washington Burlington, Massachusetts Chicago, Illinois Colorado Springs, Colorado Duluth, Georgia Edina, Minnesota Federal Way, Washington Fort Collins, Colorado Germantown, Maryland Glen Rock, New Jersey Houston, Texas Lancaster, Pennsylvania Longmont, Colorado NORTH AMERICA Markham, Ontario Marlborough, Massachusetts Matawan, New Jersey Morrisville, North Carolina Nashua, New Hampshire Petaluma, California Point-Claire, Quebec Richmond, British Columbia San Diego, California San Jose, California - S. Bascom Avenue San Jose, California - Zanker Road Santa Clara, California Seattle, Washington Sunnyvale, California Tempe, Arizona Yadley, Pennsylvania

EEMEA Athens, Greece Bracknell, United Kingdom Bristol, United Kingdom Bunnik, Netherlands Cambridge, United Kingdom Copenhagen, Denmark Gent, Belgium Bangalore, India Beijing, China Hsinchu, Taiwan Hyderabad, India Shanghai, China - West Nanjing Road Shanghai, China - Daduhe Road Sydney, Australia ASIA PACIFIC AUSTRALIA Mechelen, Belgium Ramat Gan, Israel Sophia Antipolis, France Venture House, United Kingdom Yakum, Israel Yehud, Israel Shenzhen, China Singapore Seoul, Korea Taipei, Taiwan Tokyo, Japan Qualified Entities Qualified U.S.- based tax-exempt public 501(c)(3) charities with high-quality programs and services, well- defined goals, a proven record of maximizing available resources, and a reputation for meeting objectives and reporting measured results. Governmental entities (public universities, public schools, etc.). Organizations not recognized as a 501(c)(3) public charity or as a government entity (i.e., foreign organizations, Non- Governmental Organizations (NGOs) and/or private foundations) may be considered if invited to apply by the Foundation. Broadcom Foundation will NOT entertain requests for gifts from the following entities: Individuals For-profit entities Fraternal, labor, political or social organizations Political parties or candidates Sectarian religious organizations Private schools K-12 Trade or business associations Organizations that are not publicly -supported charities exempt from tax under IRC section 501(c)(3) Organizations that discriminate on the basis of race, religion, creed, gender, national origin, or other similar factors

Broadcom Foundation will NOT entertain requests for gifts for the following activities: Advertising journals, booklets, etc Sporting events (tickets and sponsorships) Any purpose that directly benefits Broadcom The benefit of any particular individual, including Corporation or a Broadcom employee individual travel and/or study Capital campaigns (unless initiated by Broadcom Travel expenses Foundation) Trips, tours or cultural exchange programs Congresses, symposiums, and meetings University administrative, management or indirect Individual or family requests for scholarships, financial fees assistance or other types of support Organizations that collect funds for redistribution to Lobbying other nonprofit groups Technical research in support of Broadcom products Contributions in the name of a memorial tribute Political candidates, campaigns and activities Funding is generally NOT approved for: Endowments, capital or building campaigns Regular, ongoing, operating support Agencies, projects or programs normally financed by government sources Contingencies, deficits or debt reduction Contributions in the name of a memorial tribute Special fundraising event table or ticket purchases (i.e., dinners, walks, runs, rides, etc.) Matching gifts

Organization Information Contact Information Project Information Attachments * Required Fields Printable Version General Organization Information * Organization Legal Name Tax ID / EIN (for US organizations only) * Address Address 2 * City * State * Postal Code * Country * Telephone Fax Web Site Unknown Organization 0 of 64 0 of 2 0 of 10 0 of 32 0 of 32 Validate

Organization Details * Mission Statement: Provide a very brief mission statement for the organization. * Organization's History: Please provide a brief history of your organization. * Organization's Goals: Please list the goals of your organization. To Save Your Application If at any time you'd like to leave this form and save it in progress, please click on the Save Draft button and follow the instructions. You will be prompted to enter your email address and the system will then send you a web-link that you can use to resume your form at a later time. Technical Assistance Should you have technical questions regarding the online submission process, please contact Broadcom Foundation's administrator, Foundation Source, at (800) 839-1754 or requests@foundationsource.com, and they will be happy to assist you. To view more of our Frequently Asked Questions, please click here to open them in a new window. Save Draft Submit Next

Organization Information Contact Information Project Information Attachments * Required Fields Printable Version Primary Contact Information* *The primary contact should be the person responsible for questions regarding this application. * Salutation (Dr., Ms., Mr., etc.) 0 of 32 * First Name * Last Name * Title/Position 0 of 64 * Contact Phone 0 of 32 Fax 0 of 32 * Email To Save Your Application If at any time you'd like to leave this form and save it in progress, please click on the Save Draft button and follow the instructions. You will be prompted to enter your email address and the system will then send you a web-link that you can use to resume your form at a later time.

Organization Information Contact Information Project Information Attachments * Required Fields Printable Version Project Information * Project Name 0 of 50 * Requested Funding Amount (Max $2,500) 0 of 15 * Total Project Budget 0 of 15 * Which of the Eligible Non-Profit Entities does your organization represent? If other, please explain in a single sentence * Which of the following Areas or Goals does your Project fall into? STEM Education (Universities) STEM Education (Grades K-12) Health Human Services Other Graduate and post-graduate STEM research, scholarship and innovation Undergraduate STEM education Innovative Programs in K-12 STEM education with application in communities where Broadcom employees live and work Community STEM Programs located communities where Broadcom employees live and work. Closing the STEM education gap among women and ethnic and minority populations Community programs and services where Broadcom employees live and work * Please briefly describe your Program orbr

Project for which you seek funding? * Please describe Project's necessity and the target population it addresses 0 of 500 * What are the intended outcomes of your Project? * What are the Project evaluation method and tools? * Please describe your long-term plan for sustainability or scalability * Please upload your timeline, including Project/Program scheduled benchmarks * Please provide the line item budget of the project for which you are seeking funding * Please list all additional sources for funding of Project * From time to time Broadcom Corporation makes in-kind donations of used equipment. Does your project require equipment, if available, and if so, please statebrb

your specific needs. * Do Broadcom employees volunteer with your organization? If yes, please indicate any Broadcom employees that serve on your board or committees Please state any volunteer opportunities for Broadcom employees in this project or in your organization in general To Save Your Application Yes No If at any time you'd like to leave this form and save it in progress, please click on the Save Draft button and follow the instructions. You will be prompted to enter your email address and the system will then send you a web-link that you can use to resume your form at a later time. Technical Assistance Should you have technical questions regarding the online submission process, please contact Broadcom Foundation's administrator, Foundation Source, at (800) 839-1754 or requests@foundationsource.com, and they will be happy to assist you. To view more of our Frequently Asked Questions, please click here to open them in a new window. Previous Save Draft Submit Next

Organization Information Contact Information Project Information Attachments * Required Fields Printable Version Attachments Please attach the following files by clicking the "Browse" button, finding your file, and clicking "". * Most recent Annual Report * Annual Budget * List of the Governing Board * List of Key Staff Members * Short Summary about Project Directors * Organization's most recent Audited Financial Statements; if Audited Statements are not available, Internal Statements with a copy of the most recent 990 Form should be submitted Supporting Documents for Proposal, if any