Request for funding is by invitation only. To apply for funding please complete the form below. This application cannot be saved and must be completed all at once. If you are unsure/unable to complete all at once, we suggest putting your answers into a Word document, which you can save on your computer, and then copy/paste your answers into the application when you are ready to submit.

Application for Funding

Organization Form

 

2021 Funding Application - Organization Form
2. Organization Mailing Address
City
State/Province
Zip/Postal

5. Head of Organization


You may choose to highlight information such as:
  • Mission statement
  • Target populations served
  • Types of services offered
  • Major goals for your clients
  • Anything else of importance you think United Way should know about your organization
Include changes such as:
  • Agency revenue
  • Key personnel
  • Board membership (if significant)
  • Strategic direction
  • Management or agency structure
  • Changes that impact your mission or ability to meet it
  • Major changes since last review
  • Major changes expected in the coming year
Include:
  • Any organizations your agency must be, or is voluntarily, licensed or accredited by in order to deliver services
  • The status of the license or accreditation
  • The year of next renewal
See Standards of Accountability for full definitions.
Consider not only funding, but also advocacy, collaboration, volunteer support, etc.
Select all that apply.

Assurances

Enter the start date of your most recent UWMM workplace campaign in mm/dd/yy format.
"Current and active" meaning your listing is kept up-to-date.
(“Active” meaning you have logged in to the platform in the last 60 days to: update your organization profile, post new volunteer opportunities, update/maintain open volunteer opportunities, post new events or update current events, and/or track volunteer time.

Counter-terrorism Compliance

In compliance with the spirit and intent of the USA Patriot Act and other counter-terrorism laws, United Way of Mid-Maine requests that each funded organization certify that it is in compliance with United Way of Mid-Maine’s and United Way Worldwide’s compliance program.

Note: In this form, “material support and resources” means currency or monetary instruments or financial securities, financial services, lodging, training, expert advice or assistance, safe houses, false documentation or identification, communications equipment, facilities, weapons, lethal substances, explosives, personnel, transportation, and other physical assets, except medicine or religious materials. Please indicate your compliance with each of the following:
Sign or type your name below.

1. Current organizational chart highlighting UWMM-funded programs
2. Current Board of Directors member list
3. Signed Agency Compliance form (last page of the Standards of Accountability)
4. Signed Partner Agency Agreement
5. A copy of the financial statement indicated in question 10 (Annual Audit, Independent Reviewed Statement, or Compiled Statements)
Maximum upload size: 33.55MB