United Way

To add your organization to the contact list for the 2024 Impact 100 application process, comlpete the form below. The 2024 Request for Proposals will be released in early November 2023.

Organization Name:

Organization Address:

Organization Contact Name:

Organization Contact Title:

Organization Contact Email:

Organization Contact Phone:

Organization President/CEO/ED Name:

Organization President/CEO/ED Email:

Organization Development Director Name:

Organization Development Director Email:

Month of the organization's fiscal year end:

Brief description of the organization's mission (150-word limit):

0 of 150 words

Does the organization provide health and human services or advocacy related to health and human services issues or conditions? (United Way does not provide grant funding to organizations whose mission is primarily focused on arts, environmental and animal welfare organizations. More detail on funding focus areas for 2023 will be included in the upcoming Request for Proposals.)

Yes

Please enter an email address to receive a copy of this completed form:

United Way Impact 100 Interest Form