Professional Documents
Culture Documents
Section 2: Mission, Programs and Governance (Please attach additional detail if necessary)
Sector: Human Services Arts/Culture Other Youth Development Homeless Services Childcare Housing Senior Care If Human Services, main program area(s): Workforce Development Developmental Disabilities
Other: If Arts/Culture, main program area(s): Mission Statement: Performing Arts (music, dance, theater) Museum Other: Visual Arts Promoters of the Arts Rehearsal Spaces
Please briefly describe the Organizations governance structure (e.g., Board of Directors, relevant subcommittees, advisory board, etc.):
Total number of clients served by the Organization in the last fiscal year (attach additional detail if necessary):
PAG E 2 O F 4
Purchase/develop real estate Perform leasehold improvements/renovation Working capital Debt refinance Other: If the loan is to purchase/develop real estate: Does the Organization have a purchase agreement? Does the Organization have a property appraisal? Please elaborate on why the organization needs a loan: Yes Yes No No
$ $ $ $ $
How do you intend to generate funds necessary to repay the loan?: Has your Board of Directors authorized this Application?: Yes
Capital campaign
Is there a guarantor available for the loan (e.g. Board Member(s), other corporate entity): No
Unsure
Bank Name
Account Number
Average Balance $ $
EXISTING DEBT
Please supply the following information for all term loans, lines of credit, mortgages, credit cards, equipment leases, etc. Attach additional sheets with further detail if necessary. Type (e.g. loan, line of credit, credit card) Date Original Opened Amount $ $ $ $ Do any of the loans listed above have prohibitions or limitations on additional debt? Present Balance Interest Rate % % % % Maturity Date Monthly Payment
Name of Creditor
Loan #
Yes
No
Unsure
PAG E 3 O F 4
No No No
Date
PAG E 4 O F 4