Fiscal Sponsorship Program Application

Please fill out this application if you have a program or project and are seeking fiscal sponsorship.    We will review your application with our Board for approval.   You may be asked to present your program with a committee from our Board of Directors.  

You can email back to:  lbezold@fusiongroup.org  or fax to 410.889-4701

Program Name:

Contact Information:

1.   Mission statement: (if you have already one)

2.   History of Project: (what have you done so far that relates to this idea)

3.   Skills, Experience of Leader: (attach resume if available)

4.   Program/program ideas:  What does your program do? What change are you trying to make? What needs are you trying to address?

5.   Networking/Partners – identified so far:

6.   Revenue sources:

              Do you have a budget?         (please attach if so)

              Do you already have funding sources?

              What is your plan for funding?   Do you have grant writing or fundraising experience? 

7.   Organizational Development Needs:(what support do you need: examples - office, administration, grant writing, PR, etc.) 

8.   Assets – What do you have? (history, talents, skills, experience, equipment, access)

9.  Advisory Board – Do you have three people in the community who believe in your work and would serve on a steering committee or advisory board? 

10.  Fusion's mission is to work for social justice.  Any new program or project must align with that mission. How does your project work for social justice?

11.What does fiscal sponsorship mean to you?

12.   How did you hear about Fusion?

Anything else?   

Submitted by: ______________________________________

Date: _____________________________