Clear Fund Grant Application: Preliminary Questionnaire

Note: this is a reproduction of the questionnaire we used to collect information on internationally focused charities, as described in our grant application process. Submitting the form will not do anything; this page is for display purposes only.

This form is a simple, 5-minute survey intended to fill in some basic information about your organization that we weren't able to get from its Form 990. It is for our information only, to help determine your eligibility to apply for an unrestricted Clear Fund grant. It shouldn't be necessary to consult with anyone about your answers; we are looking only for very basic, general information about what your organization does, and our intent is for anyone with basic knowledge of your organization to be able to fill out this form quickly (if that isn't the case, please let us know).

Note that we do not request your mission statement because we already have it on file, along with other information from your Form 990. We ask for your EIN so that we can easily match your survey answers to your other information; if you don't provide it, we will locate your record by name instead.

Our funding priorities are not finalized, and may favor breadth in some cases and narrowness in others. Please simply answer all questions honestly, indicating the activities that are a significant part of what your organization does.

We appreciate your taking the time to fill out this form. If you have any questions, don't hesitate to contact us at grants@clearfund.org. More information about The Clear Fund is available at www.clearfund.org.

  1. Name of your organization:

  2. Employer identification number:

    (Entering this makes it easier to match your information to our existing record. If you do not enter it, we will find it by your organization's name.)

  3. Contact email:

    (All further correspondence about Clear Fund grants will be sent to this email)

  4. Contact phone:

  5. Website:

  6. Would your organization potentially be interested in applying for a one-time unrestricted grant of $20,000 to $50,000, to enable it to help more people live better lives? (Note that the application process will be thorough and competitive, although it will concern only your existing activities, i.e., no project proposal will be required.)
    Yes No

  7. Which of the following geographical regions does your organization do significant work in? Please check each region that applies.
    United States
    Central and South America
    Europe
    Asia
    Middle East
    Africa
    Other

  8. Does your organization focus on a single country?
    Yes No
    If yes, please specify:

  9. Does your organization focus specifically on children?
    Yes No

  10. Does your organization do a significant amount of political advocacy?
    Yes No

  11. Is teaching and spreading religion a significant part of your organization's mission?
    Yes No

  12. Please indicate which of the following areas make up a significant part of your organization's activities. Check each area that applies. If you provide support to other nonprofits, please indicate which types of organizations you focus on.
    Shipping supplies
    General relief services (includes most of the below - no need to specify more if your organization falls in this category)
    Water and sanitation
    Fighting and treating disease
    Preventing or correcting congenital defects
    Reproductive health services
    Other health-related services
    Construction and infrastructure development
    Debris and landmine removal
    Environmental protection and advocacy
    Food and/or clothing distribution (not shipping)
    Job training and assistance
    Loans, business development, and other microfinance
    Internet access in developing countries
    Counseling and mental health services
    K-12 education
    Early child care
    Orphanages, foster care, adoption services, and other services for abandoned children
    Assistance to other international humanitarian charities
    Other international aid

  13. Optional: how can we improve this survey?