Name of Project Entity Name - Individual, AAUW Branch/State, or Nonprofit Organization Title of Project

Fellowships and Grants 101 ACT Drive P.O. Box 4030 Iowa City, Director IA 52243-4030

Organizational Summary/Commitment Form

AAUW 2012-2013 Research and Projects

Community Action Grant

To be filled out by (1) applicants applying as nonprofit organizations and (2) organizations partnering with applicants. If there is more than one partner, please copy this form and have each partner complete his or her own copy. You must include a Statement of Commitment on a separate sheet of paper. If this Statement is not included as an attachment with this form, your application will be incomplete. Name of Organization: Date Founded: Nonprofit Annual Budget For Profit Nonprofit organizations must include a copy of their 501(c)(3) determination.

(check one of the above)

Sources of Income (e.g., grants, corporate support, endowments, dues, government grants or appropriations, sales; list by percentage): Mission Statement: Target Audience (e.g., primary clientele): Authorization (from an individual authorized to enter into contractual agreements on behalf of the organization): Name, Title Address Phone Signature

REMINDER: Statement of Commitment: In addition to this form, you must include a one- to two-paragraph statement that outlines the organizations commitment to the project in terms of time, personnel, facilities, monetary support, etc. Statements may be attached on organizational letterhead.

CAG Organizational Summary/Commitment Form