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Organization Profile

Organization Name *

Contact Name *

Title / Position *

Email Address *

Phone Number *

Website

Organization Type *

Year Established *

EIN (if applicable)

Number of Employees *

Number of Volunteers

Annual Operating Budget *

Primary Service Area *

Organization Snapshot

What is your mission? *

Who do you serve? *

Describe your primary programs or services. *

What community need are you addressing? *

Approximately how many individuals do you serve annually? *

Project Overview

Project or Initiative Name *

Describe your project or initiative. *

What problem does it solve? *

Who benefits? *

Expected outcomes? *

Estimated start date

Estimated completion date

Estimated Funding Needed *

Vision & Strategic Growth

Where do you want your organization to be? — 6 Months

12 Months

3 Years

Biggest Challenge

What does success look like?

Anything else we should know?

How You Found Us

How did you hear about Collect Virginia?

Before Submitting

By submitting this assessment, you consent to Collect Virginia storing the information you provide and using it to review your organization's funding readiness. This assessment is the first step in that process. A member of our team will follow up with you about next steps. If you do not agree to this use of your information, please do not submit this form. All information is handled in accordance with our Privacy Policy and Terms of Service.

I understand that submitting this assessment begins Collect Virginia's funding readiness review, and I consent to being contacted regarding my submission.

Funding Readiness & Resource Alignment Assessment

Before Submitting