Form 1023 Checklist

(Revised June 2006)
Application for Recognition of Exemption under Section 501 (c)(3) of the
Internal Revenue Code
Note. Retain a copy of the completed Form 1023 in your permanent records. Refer to the General Instructions
regarding Public Inspection of approved applications.
Check each box to finish your application (Form 1023). Send this completed Checklist with your filled-in
application. If you have not answered all the items below, your application may be returned to you as
incomplete.

Ei Assemble the application and materials in this order:
• Form 1023 Checklist*
• Form 2848, Power of Attorney and Declaration of Representative (if filing)
• Form 8821, Tax Information Authorization (if filing)
• Expedite request (if requesting)
• Application (Form 1023 and Schedules A through H, as required)
• Articles of organization
• Amendments to articles of organization in chronological order
• Bylaws or other rules of operation and amendments
• Documentation of nondiscriminatory policy for schools, as required by Schedule B
• Form 5768, Election/Revocation of Election by an Eligible Section 501 (c)(3) Organization To Make
Expenditures To Influence Legislation (if filing)
• All other attachments, including explanations, financial data, and printed materials or publications. Label
each page with name and EIN.

EZI User fee payment placed in envelope on top of checklist. DO NOT STAPLE or otherwise attach your check or
money order to your application. Instead, just place it in the envelope.

EZI Employer Identification Number (EIN)
EZI Completed Parts I through XI of the application, including any requested information and any required
Schedules A through H.
• You must provide specific details about your past, present, and planned activities.
• Generalizations or failure to answer questions in the Form 1023 application will prevent us from recognizing
you as tax exempt.
• Describe your purposes and proposed activities in specific easily understood terms.
• Financial information should correspond with proposed activities.

EZI Schedules. Submit only those schedules that apply to you and check either "Yes" or "No" below.

Schedule A Yes_ No _2L
Schedule E Yes - No ...L.

Schedule B Yes_ No _2L
No
S iedule F. Yes

L

Schedule C Yes_ NoL

Schedule G Yes_ No...L.

Schedule D Yes_ No-2L

Schedule H Yes.. No-2L

I
An exact copy of your complete articles of organization (creating document). Absence of the proper purpose
and dissolution clauses is the number one reason for delays in the issuance of determination letters.
• Location of Purpose Clause from Part Ill, line 1 (Page, Article and Paragraph Number) _Page 1, Art. 3
• Location of Dissolution Clause from Part Ill, line 2b or 2c (Page, Article and Paragraph Number) or by
Page 3, Art. 6
operation of state law
Signature of an officer, director, trustee, or other official who is authorized to sign the application.'
• Signature at Part XI of Form 1023.
Your name on the application must be the same as your legal name as it appears in your articles of
organization.
Send completed Form 1023, user fee payment, and all other required information, to:

lii'

internal Re ue Service
P.O. Box
ZI?Z
Covington, KY 41012-0192
If you are using express mail or a delivery service, send Form 1023, user fee payment, and attachments to:
Internal Revenue Service
201 West Rivercenter Blvd.
Attn: Extracting Stop 312
Covington, KY 41011

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Form

2848

(Rev. June 2008)
Department of the Treasury
Internal Revenue service

Power of Attorney
and Declaration of Representative
-

Type or print

For IRS Use Only
Received by:

See the separate instructions.

Name

IThlI Power of Attorney
Telephone
Caution: Form 2848 will not be honored for any purpose other than representation before the IRS,
Function
1 Taxpayer information. Taxpayer(s) must sign and date this form on page 2, line 9.
Date
Social security number(s)
Taxpayer name(s) and address
Employer identification
number
StudentsFirst Institute
406 7th St NW, 2nd Floor
27
3659574
Washington, DC 20004
Daytime telephone number
Plan number (if applicable)
654-6200
202 )
hereby appoint(s) the following representative(s) as attorney(s)-in-fact:
2 Representat
Name and address

must sign and date this form on page 2, Part II.

Marc E. Elias
700 13th St NW, Suite 600, Washington, DC 20005
Name and address
Ezra W. Reese
700 13th St NW, Suite 600, Washington, DC 20005

CAFNo - ---------------- -------------------Telephone No. ........ .202.654.6200
Fax No------------- 202-654.621
Check if new: Address E
Telephone No. 0
Fax No. LI
CAF No.
3.96-71.R
?8
Telephone No. ........
.. .&0.
Fax No..............
Check if new: Address
Telephone No. Z

26?i1

Fax No. 0

Name and address

CAF No
Telephone No
FaxNo.----------------------------------------Check if new: Address 0
Telephone No. 0
Fax No. 0
to represent the taxpayer(s) before the Internal Revenue Service for the following tax matters:
3 Tax matters

Type of Tax (Income, Employment, Excise, etc.)
or Civil Penalty (see the instructions for line 3)
Application for Recognition of Exemption

Tax Form Number
(1040, 941, 720, etc.)
1023

Year(s) or Period(s)
(see the instructions for line 3)
2011-12

4 Specific use not recorded on Centralized Authorization File (CAF). If the power of attorney is for a specific use not recorded on CAF,
check this box. See the instructions for Line 4. Specific Uses Not Recorded on CAF ..............

0

5 Acts authorized. The representatives are authorized to receive and inspect confidential tax information and to perform any and all acts that
I (we) can perform with respect to the tax matters described on line 3, for example, the authority to sign any agreements, consents, or other
documents. The authority does not include the power to receive refund checks (see line 6 below), the power to substitute another representative
or add additional representatives, the power to sign certain returns, or the power to execute a request for disclosure of tax returns or return
Information to a third party. See the line 5 Instructions for more information.
Exceptions. An unenrolled return preparer cannot sign any document for a taxpayer and may only represent taxpayers in limited situations.
See Unenrolled Return Preparer on page 1 of the instructions. An enrolled actuary may only represent taxpayers to the extent provided in
section 10.3(d) of Treasury Department Circular No. 230 (Circular 230). An enrolled retirement plan administrator may only represent taxpayers
to the extent provided in section 10.3(e) of Circular 230. See the line 5 instructions for restrictions on tax matters partners. In most cases,
the student practitioner's (levels k and I) authority is limited (for example, they may only practice under the supervision of another practitioner).
List any specific additions or deletions to the acts otherwise authorized in this power of attorney...........................................

6 Receipt of refund checks. If you want to authorize a representative named on line 2 to receive, BUT NOT TO ENDORSE OR CASH, refund
checks, initial here
and list the name of that representative below.
Name of representative to receive refund check(s)
For Privacy Act and Paperwork Reduction Act Notice, see page 4 of the instructions.

Cat. No. 11980J

Form

2848

(Rev. 6-2008)

Page

Fo'm 2845 (Rev. 62OO8)

7 Notices and communications. Original notices and other written communications will be sent to you and a copy to the first
representative listed on line 2.
a If you also want the second representative listed to receive a copy of notices and communications, check this box .....
b U you do not want any notices or communications sent to your representative(s), check this box

"

8 Retention/revocation of prior power(s) of attorney. The filing of this power of attorney automatically revokes all cattier power(s) of
attorney on file with the Internal Revenue Service for the same tax matters and years or periods covered by this document. if youdo not
want to revoke a prior power of attorney, check here........................

2

U
0

YOU MUST ATTACH A COPY OF ANY POWER OF ATTORNEY YOU WANT TO REMAIN IN EFFECT.
9 Signature of taxpayer(s). If a tax matter concerns a joint return, both husband and wife must signif joint representation is requested,
otherwise, see the Instructions. If signed by a corporate officer, partner, guardian, tax matters partner, executor, receiver, administrator, or
trustee on behalf of the taxpayer. I certify that I have the authority to execute this form on behalf of the taxpayer.
10- IF NOT SIG D A D D, THIS POWER OF ATTORNEY WILL BE RETURNED.
President
Signature
Michelle Rhea

Date

0

GOD

PIN Number

Print Name

..............................
Print Name
IflHlI Declaration

SludentsFlrst Institute
Print name

Date

Signature

Title (if applicable)

of taxpayer from line 1 if other than individual

Title (d applicable)

00000
PIN Number

of Representative

Cautlopi: Students with a special order to represent taxpayers In qualified Low Income Taxpayer Clinics or the Student Tax Clinic Program (levels
k and (J, see the instructions for Part II.
Under penalties of perjury, I declare that:
• I am not currently under suspension or disbarment from practice before the Internal Revenue Service;
• I am aware of regulations contained In Circular 230 (31 CFR, Part 10), as amended, concerning the practice of attorneys, certified public
accountants, enrolled agents, enrolled actuaries, and others;
• I am authorized to represent the taxpayer(s) identified in Part I for the tax matter(s) specified there: and
• I am one of the following:
Attorney—a member in good standing of the bar of the highest court of the jurisdiction shown below.
• b Certified Public Accountant—duly, qualified to practice as a certified public accountant in the jurisdiction shown below.
c Enrolled Agent—enrolled as an agent under the requirements of Circular 230.
d Officer—a bona tide officer of the taxpayer's organization.
o Full-Time Employee—a full-time employee of the taxpayer.
I Family Member--a member of the taxpayer's immediate family (for example, spouse, parent, child, brother, or aiste4.
9 Enrolled Actuary—enrolled as an actuary by the Joint Board for the Enrollment of Actuaries under 29 U.S.C. 1242 (the authority to
practice before the Internal Revenue Service is limited by section 10.3(d) of Circular 230).
h Unwirolled Return Preparer—the authority to practice before the Internal Revenue Service is limited by Circular 230, section
1 0.7(cX 1 ) ril. You must have prepared the return in question and the return must be under examination by the IRS. See Unonrolled
Return Preparer on page 1 of the Instructions.
k Student Attorney—student who receives permission to practice before the IRS by virtue of their status as a law student under section
10.7(d) of Circular 230.
I Student CPA—Student who receives permission to practice before the IRS by virtue of their status as a CPA student under section
10.7(d) of Circular 230.
r Enrolled Retirement Plan Agent—enrolled as a retirement plan agent under the requirements of Circular 230 (the authority to practice
before the Internal Revenue Service is limited by section 10.3(e)).
' IF THIS DECLARATION OF REPRESENTATIVE IS NOT SIGNED AND DATED, THE POWER OF ATTORNEY WILL

BE RETURNED. See the Part II Instructions.
Designation—insert Jurisdiction (state) or
above letter (a—r)
Identification

I

Date

DC

Fotm

2848 (Rev. 6-2008)

1023

(Rev. June 20(36)

Application for Recognition of Exemption

OMB No. 1545-0056

Note: If exempt status is
approved, this
application will be open
for oublic insDection.

Under Section 501(c)(3) of the Internal Revenue Code

Department of the Treasury
Internal Revenue Service

Use the instructions to complete this application and for a definition of all bold items. For additional help, call IRS Exempt
Organizations Customer Account Services toll-free at 1-877-829-5500. Visit our website at www.irs.gov for forms and
publications. If the required information and documents are not submitted with payment of the appropriate user fee, the
application may be returned to you.
Attach additional sheets to this application if you need more space to answer fully. Put your name and EIN on each sheet and
identify each answer by Part and line number. Complete Parts I - XI of Form 1023 and submit only those Schedules (A through
H) that apply to you.
Identification of Applicant
I Full name of organization (exactly as it appears in your organizing document)

2 do Name (if applicable)

StudentsFirst Institute
3 Mailing address (Number and Street) (See instructions)

406 7th St NW

Room/Suite 4 Employer Identification Number (EIN)
2nd Floor

City or town, state or country, and ZIP + 4
Washington, DC 20004

27-3659685
5 Month the annual accounting period ends (01 - 12)
07

6 Primary contact (officer, directOr, trustee, or authorized representative)
a Name: Ezra W. Reese

202.654.6200

b Phone:
c Fax: (optional)

202.654.6211

7 Are you represented by an authorized representative, such as an attorney or accountant? If "Yes,"
provide the authorized representative's name, and the name and address of the authorized
representative's firm. Include a completed Form 2848, Power of Attorney and Declaration of
Representative, with your application if you would like us to communicate with your representative.

IlI

Yes

0

No

8 Was a person who is not one of your officers, directors, trustees, employees, or an authorized
representative listed in line 7, paid, or promised payment, to help plan, manage, or advise you about
the structure or activities of your organization, or about your financial or tax matters? If "Yes,"
provide the person's name, the name and address of the person's firm, the amounts paid or
promised to be paid, and describe that person's role.

0

Yes

0

No

0

Yes

121 No

9a Organization's website:
b Organization's email: (optional)
10 Certain organizations are not required to file an information return (Form 990 or Form 990-EZ). If you
are granted tax-exemption, are you claiming to be excused from filing Form 990 or Form 990-EZ? If
"Yes," explain. See the instructions for a description of organizations not required to file Form 990 or
Form 990-EZ.
11 Date incorporated if a corporation, or formed, if other than a corporation. (MMIDD/YYYY)

12 Were you formed under the laws of a foreign country?
If "Yes," state the country.
For Paperwork Reduction Act Notice, see page 24 of the instructions,

cat. No. 17133K

10 / 12 /

El Yes
Form

2010

0

No

1023 (Rev. 6-2006)

Form 1023 (Rev. 6-2006)

Name: StudentsFirst

Initiative

EIN: 27- 3659685

Page

2

iIThitI Organizational Structure
You must be a corporation (including a limited liability company), an unincorporated association, or a trust to be tax exempt.
(See instructions.) DO NOT file this form unless you can check "Yes" on lines 1, 2, 3, or 4.
1 Are you a corporation? If "Yes," attach a copy of your articles of incorporation showing certification E21 Yes
of filing with the appropriate state agency. Include copies of any amendments to your articles and
be sure they also show state filing certification.

0 No

2 Are you a limited liability company (LLC)? If Yes," attach a copy of your articles of organization showing 0 Yes
certification of filing with the appropriate state agency. Also, if you adopted an operating agreement, attach
a copy. Include copies of any amendments to your articles and be sure they show state filing certification.
Refer to the instructions for circumstances when an LLC should not file its own exemption application.

0 No

3 Are you an unincorporated association? If "Yes," attach a copy of your articles of association,
constitution, or other similar organizing document that is dated and includes at least two signatures.
Include signed and dated copies of any amendments.

El Yes

121 No

4a Are you a trust? If "Yes," attach a signed and dated copy of your trust agreement. Include signed
and dated copies of any amendments.
b Have you been funded? If "No," explain how you are formed without anything of value placed in trust.

LI Yes

121 No

0 Yes
5 Have you adopted bylaws? If "Yes," attach a current copy showing date of adoption. If "No," explain jj Yes
how your officers, directors, or trustees are selected.
-
90M
Required Provisions in Your Organizing Document

0 No

ü No

The following questions are designed to ensure that when you file this application, your organizing document contains the required provisions
to meet the organizational test under section 501(c)(3). Unless you can check the boxes in both lines 1 and 2, your organizing document
does not meet the organizational test. DO NOT file this application until you have amended your organizing document. Submit your
original and amended organizing documents (showing state filing certification if you are a corporation or an LLC) with your application.
1 Section 501 (c)(3) requires that your organizing document state your exempt purpose(s), such as charitable,
religious, educational, and/or scientific purposes. Check the box to confirm that your organizing document
meets this requirement. Describe specifically where your organizing document meets this requirement, such as
a reference to a particular article or section in your organizing document. Refer to the instructions for exempt
purpose language. Location of Purpose Clause (Page, Article, and Paragraph): Page 1, Art. 3
2a Section 501(c)(3) requires that upon dissolution of your organization, your remaining assets must be used exclusively
for exempt purposes, such as charitable, religious, educational, and/or scientific purposes. Check the box on line 2a to
confirm that your organizing document meets this requirement by express provision for the distribution of assets upon
dissolution. If you rely on state law for your dissolution provision, do not check the box on line 2a and go to tine 2c.
2b If you checked the box on line 2a, specify the location of your dissolution clause (Page, Article, and Paragraph).
Do not complete line 2c if you checked box 2a. Page J, Art. b
2c See the instructions for information about the operation of state law in your particular state. Check this box if
you rely on operation of state law for your dissolution provision and indicate the state:
IIT1k'1 Narrative Description of Your Activities

0

Using an attachment, describe your past, present, and planned activities in a narrative. If you believe that you have already provided some of
this information in response to other parts of this appliOation, you may summarize that information here and refer to the specific parts of the
application for supporting details. You may also attach representative copies of newsletters, brochures, or similar documents for supporting
details to this narrative. Remember that if this application is approved, it will, be open for public inspection. Therefore, your narrative
description of activities should be thorough and accurate. Refer to the instructions for information that must be included in your description.

EM

Compensation and Other Financial Arrangements With Your Officers, Directors, Trustees,
Employees, and Independent Contractors

la List the names, titles, and mailing addresses of all of your officers, directors, and trustees. For each person listed, state their
total annual compensation, or proposed compensation, for all services to the organization, whether as an officer, employee, or
other position. Use actual figures, if available. Enter "none" if no compensation is or will be paid. If additional space is needed,
attach a separate sheet. Refer to the instructions for information on what to include as compensation.
Name

Title

Michelle Rhee

President! Director

David Coleman

Treasurer! Director

Ann-Margaret Michael

Secretary I Director

Jason Zimba

Director

Mailing address

406 7th St NW
Washington, DC 20004
I Union Square South, 22E
New York, NY 10003
I Union Square South, 22.
1135 South Stream Road
Bennington VT 05201

Compensation amount
(annual actual or estimated)

$125,000
$0
$0
$0

Form 1023 (Rev. 6-2006)

Form 1023 (Rev. 6-2006)

Name: StudentsFirst

Initiative

EIN:

27— 3659685

Page

3

•aia Compensation and Other Financial Arrangements With Your Officers, Directors, Trustees,
Employees, and Independent Contractors

(Continued)

b List the names, titles, and mailing addresses of each of your five highest compensated employees who receive or will
receive compensation of more than $50,000 per year. Use the actual figure, if available. Refer to the instructions for
information on what to include as compensation. Do not include officers, directors, or trustees listed in line 1 a.
Name

Title

Mailing address

Dmitri Mehihorn

Coo

Mafara Hobson

Press Secretary

Kathleen deLaski

Editor in Chief

Kate Gottfredson

Vice President - Policy

Bridget Davis

Research Director

Compensation amount
(annual actual or estimated)

406 7th St NW
Washington, DC 20004
406 7th St NW
.DC
Washinato-n-.-,D
- - 20004
406 7th St NW
Washington, DC 20004
406 7th St NW
Washington, DC 20004
406 7th St NW
Washinaton. DC 20004

$112,500
$135,000
$170,000
$93,750
$112,500

c List the names, names of businesses, and mailing addresses of your five highest compensated independent contractors
that receive or will receive compensation of more than $50,000 per year. Use the actual figure, if available. Refer to the
instructions for information on what to include as compensation.
Name

Title

Perkins Cole LLP

Outside Counsel

Blue State Digital

Website & Internet Services

SKDKnickerbocker

Mass Media Consultants

Mailing address

Compensation amount
(annual actual or estimated)

700 13th St NW, Suite 600
Washington, DC 02005
406 7th Street NW 3rd Floor
Washington, DC 20004
1818 N St. NW, Suite 450
Washinaton. DC 20036

$200,000
$288,000
$270,000

The following "Yes" or No" questions relate to past, present, or planned relationships, transactions, or agreements with your officers,
directors, trustees, highest compensated employees, and highest compensated independent contractors listed in lines la, 1b, and 1c.
2a Are any of your officers, directors, or trustees related to each other through family or business
relationships? If "Yes," identify the individuals and explain the relationship.

L1 Yes

0 No

b Do you have a business relationship with any of your officers, directors, or trustees other than
through their position as an officer, director, or trustee? If "Yes," identify the individuals and describe
the business relationship with each of your officers, directors, or trustees.

0 Yes

0 No

c Are any of your officers, directors, or trustees related to your highest compensated employees or
highest compensated independent contractors listed on lines lb or lc through family or business
relationships? If "Yes," identify the individuals and explain the relationship.

0 Yes

IZI No

EZI Yes

0 No

a Do you or will the individuals that approve compensation arrangements follow a conflict of interest policy?
LZJ Yes
b Do you or will you approve compensation arrangements in advance of paying compensation?
IZI Yes
c Do you or will you document in writing the date and terms of approved compensation arrangements? 0 Yes

0 No
0 No
0 No

3a For each of your officers, directors, trustees, highest compensated employees, and highest
compensated independent contractors listed on lines la, ib, or ic, attach a list showing their name,
qualifications, average hours worked, and duties.
b Do any of your officers, directors, trustees, highest compensated employees, and highest
compensated independent contractors listed on lines la, lb, or ic receive compensation from any
other organizations, whether tax exempt or taxable, that are related to you through common
control? If "Yes," identify the individuals, explain the relationship between you and the other
organization, and describe the compensation arrangement.
4 In establishing the compensation for your officers, directors, trustees, highest compensated
employees, and highest compensated independent contractors listed on lines 1 a, 1b, and 1c, the
following practices are recommended, although they are not required to obtain exemption. Answer
"Yes" to all the practices you use.

Form

1023

(Rev. 6-2006)

Form 1023 (Rev. 6-2006)

UTI1

Name: StudentsFirst

Initiative

I

EIN:

27 - 3659685

Page 4

Compensation and Other Financial Arrangements With Your Officers, Directors, Trustees,
Employees, and Independent Contractors (Continued)

d Do you or will you record in writing the decision made by each individual who decided or voted on
compensation arrangements?

Ij Yes

0 No

e Do you or will you approve compensation arrangements based on information about compensation paid by El1 Yes
similarly situated taxable or tax-exempt organizations for similar services, current compensation surveys
compiled by independent firms, or actual written offers from similarly situated organizations? Refer to the
instructions for Part V, lines la, lb. and ic, for information on what to include as compensation.

0 No

f Do you or will you record in writing both the information on which you relied to base your decision
and its source?
g If you answered "No" to any item on lines 4a through 4f, describe how you set compensation that is
reasonable for your officers, directors, trustees, highest compensated employees, and highest
compensated independent contractors listed in Part V, lines la, ib, and ic.

0 No

111

Yes

5a Have you adopted a conflict of interest policy consistent with the sample conflict of interest policy
es
0 No
in Appendix A to the instructions? If "Yes," provide a copy of the policy and explain how the policy
has been adopted, such as by resolution of your governing board. If "No," answer lines 5b and 5c.
b What procedures will you follow to assure that persons who have a conflict of interest will not have
influence over you for setting their own compensation?
c What procedures will you follow to assure that persons who have a conflict of interest will not have
influence over you regarding business deals with themselves?
Note: A conflict of interest policy is recommended though it is not required to obtain exemption.
Hospitals, see Schedule C, Section I, line 14.
6a Do you or will you compensate any of your officers, directors, trustees, highest compensated employees,
and highest compensated independent contractors listed in lines la, lb, or ic through non-fixed
payments, such as discretionary bonuses or revenue-based payments? If "Yes," describe all non-fixed
compensation arrangements, including-how the amounts are determined, who is eligible for such
arrangements, whether you place a limitation on total compensation, and how you determine or will
determine that you pay no more than reasonable compensation for services. Refer to the instructions for
Part d, lines la, lb, and ic, for information on what to include as compensation.
b Do you or will you compensate any of your employees, other than your officers, directors, trustees,
or your five highest compensated employees who receive or will receive compensation of more than
$50,000 per year, through non-fixed payments, such as discretionary bonuses or revenue-based
payments? If "Yes," describe all non-fixed compensation arrangements, including how the amounts
are or will be determined, who is or will be eligible for such arrangements, whether you place or will
place a limitation on total compensation, and how you determine or will determine that you pay no
more than reasonable compensation for services. Refer to the instructions for Part V, lines 1 a, 1 b,
and lc, for information on what to include as compensation.

0 Yes

Yes

IZI

No

7a Do you or will you purchase any goods, services, or assets from any of your officers, directors,
trustees, highest compensated employees, or highest compensated independent contractors listed in
lines la, ib, or lc? If "Yes," describe any such purchase that you made or intend to make, from
whom you make or will make such purchases, how the terms are or will be negotiated at arm's
length, and explain how you determine or will determine that you pay no more than fair market
value. Attach copies of any written contracts or other agreements relating to such purchases.

0 Yes

IZI

No

b Do you or will you sell any goods, services, or assets to any of your officers, directors, trustees,
highest compensated employees, or highest compensated independent contractors listed in lines 1 a,
ib, or ic? If "Yes," describe any such sales that you made or intend to make, to whom you make or
will make such sales, how the terms are or will be negotiated at arm's length, and explain how you
determine or will determine you are or will be paid at least fair market value. Attach copies of any
written contracts or other agreements relating to such sales.

0 Yes

!Z] No

8a Do you or will you have any leases, contracts, loans, or other agreements with your officers, directors, 0 Yes
trustees, highest compensated employees, or highest compensated independent contractors listed in
lines la, lb, or ic? If "Yes," provide the information requested in lines. 8b through 8f.

IZI No

0

EJ No

b Describe any written or oral arrangements that you made or intend to make.
c Identify with whom you have or will have such arrangements.
d Explain how the terms are or will be negotiated at arm's length.
e Explain how you determine you pay no more than fair market value or you are paid at least fair market value.
f Attach copies of any signed leases, contracts, loans, or other agreements relating to such arrangements.
9a Do you or will you have any leases, contracts, loans, or other agreements with any organization in
which any of your officers, directors, or trustees are also officers, directors, or trustees, or in which
any individual officer, director, or trustee owns more than a 35% interest? If "Yes," provide the
information requested in lines 9b through 9f.

121 Yes

Form

1023

0 No

(Rev. 6-2006)

Form 1023 (Rev. 6-2006)

Name: StudentsFirst

Initiative

EIN:

27 - 3659685

Page

5

I1ThI'1 Compensation and Other Financial Arrangements With Your Officers, Directors, Trustees,
Employees, and Independent Contractors (Continued)
b Describe any written or oral arrangements you made or intend to make.
c Identify with whom you have or will have such arrangements.
d Explain how the terms are or will be negotiated at arm's length.
e Explain how you determine or will determine you pay no more than fair market value or that you are
paid at least fair market value.
f Attach a copy of any signed leases, contracts, loans, or other agreements relating to such arrangements.

ITh'dI Your Members and Other Individuals and Organizations That Receive Benefits From You
The following "Yes" or "No" questions relate to goods, services, and funds you provide to individuals and organizations as part
of your activities. Your answers should pertain to past, present, and planned activities. (See instructions.)
I In carrying out your exempt purposes, do you provide goods, services, or funds to individuals? If
"Yes," describe each program that provides goods, services, or funds to individuals.
b In carrying out your exempt purposes, do you provide goods, services, or funds to organizations? If
"Yes," describe each program that provides goods, services, or funds to organizations.

0 Yes

Z1

No
No

0

Yes

0

2 Do any of your programs limit the provision of goods, services, or funds to a specific individual or
group of specific individuals? For example, answer "Yes," if goods, services, or funds are provided
only for a particular individual, your members, individuals who work for a particular employer, or
graduates of a particular school. If "Yes," explain the limitation and how recipients are selected for
each program.

0

Yes

IlI No

3 Do any individuals who receive goods, services, or funds through your programs have a family or
business relationship with any officer, director, trustee, or with any of your highest compensated
employees or highest compensated independent contractors listed in Part V, lines la, ib, and ic? If
"Yes," explain how these related individuals are eligible for goods, services, or funds.

0

Yes

21

LI

Yes

121 No

D Yes

121 No

No

IFJI'1lI Your History
The following "Yes" or "No" questions relate to your history. (See instructions.)
1 Are you a successor to another organization? Answer "Yes," if you have taken or will take over the
activities of another organization; you took over 25% or more of the fair market value of the net
assets of another organization; or you were established upon the conversion of an organization from
for-profit to non-profit status. If "Yes," complete Schedule G.
2 Are you submitting this application more than 27 months after the end of the month in which you
were legally formed? If "Yes," complete Schedule E.

ITh'4llI Your Specific Activities
The following "Yes" or "No" questions relate to specific activities that you may conduct. Check the appropriate box. Your
answers should pertain to past, present, and planned activities. (See instructions.)
I Do you support or oppose candidates in political campaigns in any way? If "Yes," explain.

0 Yes

121 No

2a Do you attempt to influence legislation? If "Yes," explain how you attempt to influence legislation
and complete line 2b. If "No" go to line 3a.
-

121 Yes

LI No

0 Yes

121

No

Yes

121

No

0 Yes

121

No

b Have you made or are you making an election to have your legislative activities measured by
expenditures by filing Form 5768? If "Yes," attach a copy of the Form 5768 that was already filed or
attach a completed Form 5768 that you are filing with this application. If "No," describe whether your
attempts to influence legislation are a substantial part of your activities. Include the time and money
spent on your attempts to influence legislation as compared to your total activities.
3a Do you or will you operate bingo or gaming activities? If "Yes," describe who conducts them, and
list all revenue received or expected to be received and expenses paid or expected to be paid in
operating these activities. Revenue and expenses should be provided for the time periods specified
in Part IX, Financial Data.
b Do you or will you enter into contracts or other agreements with individuals or organizations to
conduct bingo or gaming for you? If "Yes," describe any written or oral arrangements that you made
or intend to make, identify with whom you have or will have such arrangements, explain how the
terms are or will be negotiated at arm's length, and explain how you determine or will determine you
pay no more than fair market value or you will be paid at least fair market value. Attach copies or
any written contracts or other agreements relating to such arrangements.

0

c List the states and local jurisdictions, including Indian Reservations, in which you conduct or will
conduct gaming or bingo.
Form 1023 (Rev. 6-2006)

Form 1023 (Rev. 6-2006)
Name: StudentsFirst Initiative
ITh'AllI Your Specific Activities (Continued)

EIN:

27 - 3659685

Page

4a Do you or will you undertake fundraising? If "Yes," check all the fundraising programs you do or will 121 Yes
conduct. (See instructions.)
121 mail solicitations
[J phone solicitations
121 email solicitations
0 accept donations on your website
0 receive donations from another organization's website
121 personal solicitations
0 government grant solicitations
0 vehicle, boat, plane, or similar donations
0 Other
121 foundation grant solicitations

6

El No

Attach a description of each fundraising program.
b Do you or will you have written or oral contracts with any individuals or organizations to raise funds
for you? If "Yes," describe these activities. Include all revenue and expenses from these activities
and state who conducts them. Revenue and expenses should be provided for the time periods
specified in Part IX, Financial Data. Also, attach a copy of any contracts or agreements.

0 Yes

121 No

c Do you or will you engage in fundraising activities for other organizations? If "Yes," describe these
arrangements. Include a description of the organizations for which you raise funds and attach copies
of all contracts or agreements.

0 Yes

121 No

0 Yes

121 No

d List all states andlocal jurisdictions in which you conduct fundraising. For each state or local
jurisdiction listed, specify whether you fundraise for your own organization, you fundraise for another
organization, or another organization fundraises for you.
e Do you or will you maintain separate accounts for any contributor under which the contributor has
the right to advise on the use or distribution of funds? Answer "Yes" if the donor may provide advice
on the types of investments, distributions from the types of investments, or the distribution from the
donor's contribution account. If "Yes," describe this program, including the type of advice that may
be provided and submit copies of any written materials provided to donors.
5 Are you affiliated with a governmental unit? If "Yes," explain.

0 Yes

ILl No

6a Do you or will you engage in economic development? If "Yes," describe your program.
b Describe in full who benefits from your economic development activities and how the activities
promote exempt purposes.

0 Yes

121 No

7a Do or will persons other than your employees or volunteers develop your facilities? If "Yes," describe 0 Yes
each facility, the role of the developer, and any business or family relationship(s) between the
developer and your officers, directors, or trustees.

ELI No

b Do or will persons other than your employees or volunteers manage your activities or facilities? If
"Yes," describe each activity and facility, the role of the manager, and any business or family
relationship(s) between the manager and your officers, directors, or trustees.

0 Yes

ELI No

8 Do you or will you enter into joint ventures, including partnerships or limited liability companies
treated as partnerships, in which you share profits and losses with partners other than section
501 (c)(3) organizations? If "Yes," describe the activities of these joint ventures in which you
participate.

El Yes

0 No

9a Are you applying for exemption as a childcare organization under section 501(k)? If "Yes," answer
lines 9b through 9d. If "No," go to line 10.

DYes 0 No

c If there is a business or family relationship between any manager or developer and your officers,
directors, or trustees, identify the individuals, explain the relationship, describe how contracts are
negotiated at arm's length so that you pay no more than fair market value, and submit a copy of any
contracts or other agreements.

b Do you provide child care so that parents or caretakers of children you care for can be gainfully
employed (see instructions)? If "No," explain how you qualify as a childcare organization described
in section 501(k).

DYes El No

c Of the children for whom you provide child care, are 85% or more of them cared for by you to
enable their parents or caretakers to be gainfully employed (see instructions)? If "No," explain how
you qualify as a childcare organization described in section 501(k).

El Yes

d Are your services available to the general public? If "No," describe the specific group of people for
whom your activities are available. Also, see the instructions and explain how you qualify as a
childcare organization described in section 501(k).

El Yes DNo

10 Do you or will you publish, own, or have rights in music, literature, tapes, artworks, choreography,
scientific discoveries, or other intellectual property? If "Yes," explain. Describe who owns or will
own any copyrights, patents, or trademarks, whether fees are or will be charged, how the fees are
determined, and how any items are or will be produced, distributed, and marketed.

El Yes

Form

1023

El No

121 No

(Rev. 6-2006)

Form 1023 (Rev. 6-2006)

Name: StudentsFirst

Initiative

EIN: 27 - 3659685

Page 7

1flTh'1ll1 Your Specific Activities (Continued)

11 Do you or will you accept contributions of: real property; conservation easements; closely held
securities; intellectual property such as patents, trademarks, and copyrights; works of music or art;
licenses; royalties; automobiles, boats, planes, or other vehicles; or collectibles of any type? If "Yes,'
describe each type of contribution, any conditions imposed by the donor on the contribution, and
any agreements with the donor regarding the contribution.

0 Yes

IZ No

12a Do you or will you operate in a foreign country or countries? If "Yes," answer lines 12b through
12d. If "No," go to line 13a.
b Name the foreign countries and regions within the countries in which you operate.
c Describe your operations in each country and region in which you operate.
d Describe how your operations in each country and region further your exempt purposes.

0 Yes

121 No

13a Do you or will you make grants, loans, or other distributions to organization(s)? If "Yes," answer lines 121 Yes
13b through 13g. If "No," go to line 14a.

0 No

b Describe how your grants, loans, or other distributions to organizations further your exempt purposes.
c Do you have written contracts with each of these organizations? If "Yes," attach a copy of each contract.
d Identify each recipient organization and any relationship between you and the recipient organization.
e Describe the records you keep with respect to the grants, loans, or other distributions you make.
f Describe your selection process, including whether you do any of the following:
(j) Do you require an application form? If "Yes," attach a copy of the form.
(ii) Do you require a grant proposal? If "Yes," describe whether the grant proposal specifies your
responsibilities and those of the grantee, obligates the grantee to use the grant funds only for the
purposes for which the grant was made, provides for periodic written reports concerning the use
of grant funds, requires a final written report and an accounting of how grant funds were used,
and acknowledges your authority to withhold and/or recover grant funds in case such funds are,
or appear to be, misused.

0 Yes

121 No

LI Yes

121

E21 Yes

No
0 No

0 Yes

121

g Describe your procedures for oversight of distributions that assure you the resources are used to
further your exempt purposes, including whether you require periodic and final reports on the use of
resoUrces.
14a Do you or will you make grants, loans, or other distributions to foreign organizations? If "Yes,"
answer lines 14b through 14f. If "No," go to line 15.

No

b Provide the name of each foreign organization, the country and regions within a country in which
each foreign organization operates, and describe any relationship you have with each foreign
organization.
c Does any foreign organization listed in line 14b accept contributions earmarked for a specific country LI Yes
or specific organization? If "Yes," list all earmarked organizations or countries.

LI No

d Do your contributors know that you have ultimate authority to use contributions made to you at your 0 Yes
discretion for purposes consistent with your exempt purposes? If "Yes," describe how you relay this
information to contributors.

LI No

e Do you or will you make pre-grant inquiries about the recipient organization? If "Yes," describe these 0 Yes
inquiries, including whether you inquire about the recipient's financial status, its tax-exempt status
under the Internal Revenue Code, its ability to accomplish the purpose for which the resources are
provided, and other relevant information.
I Do you or will you use any additional procedures to ensure that your distributions to foreign
organizations are used in furtherance of your exempt purposes? If "Yes," describe these procedures,
including site visits by your employees or compliance checks by impartial experts, to verify that grant
funds are being used appropriately.

LI Yes

0

No

LI No

Form 1023 (Rev. 6-2006)

e. .,4...e..

I:e;...i;.

-ry

')fltflrfle

16 Are you applying for exemption as a cooperative hospital service organization under section
501(e)? If "Yes," explain.

0 Yes

0 No

17 Are you applying for exemption as a cooperative service organization of operating educational
organizations under section 501(0? If "Yes." exolain.

18 Are you applying for exemption as a charitable risk pool under section 501

0 Yes

LZI No

19 Do you or will you operate a school? If "Yes," complete Schedule B. Answer "Yes," whether you
operate a school as your main function or as a secondary activity.
20 Is your main function to provide hospital or medical care? If "Yes," complete Schedule C.

0 Yes

IJ No

0 Yes
0 Yes

IZI No
IZI No

22 Do you or will you provide scholarships, fellowships, educational loans, or other educational grants to 0 Yes
individuals, including grants for travel, study, or other similar purposes? If "Yes," complete
Schedule H.
Note: Private foundations may use Schedule H to request advance approval of individual grant
procedures.

IZI No

1023

(Rev. 6-2006)

21 Do you or will you provide low-income housing or housing for the elderly or handicapped? If
"Yes," complete Schedule F.

No

Form

Form 1023 (Rev. 6-2006)

Name: StudentsFirst Initiative

EIN: 27 - 3659685

page 9

IThIEI Financial Data
For purposes of this schedule, years in existence refer to completed tax years. If in existence 4 or more years, complete the
schedule for the most recent 4 tax years. If in existence more than 1 year but less than 4 years, complete the statements for
each year in existence and provide projections of your likely revenues and expenses based on a reasonable and good faith
estimate of your future finances for a total of 3 years of financial information. If in existence less than 1 year, provide projections
of your likely revenues and expenses for the current year and the 2 following years, based on a reasonable and good faith
estimate of your future finances for a total of 3 years of financial information. (See instructions.)
A. Statement of Revenues and Expenses
Type of revenue or expense

Current tax year

3 prior tax years or 2 succeeding tax years

(a) From .L41?. (b) From
To
To ..!?P!i..

1 Gifts, grants, and
contributions received (do not
include unusual grants)
3 Gross investment income
4 Net unrelated business
income
5 Taxes levied for your benefit

O
0
0
Ol
01

6 Value of services or facilities
furnished by a governmental
unit without charge (not
including the value of services
generally furnished to the
public without charge)
7 Any revenue not otherwise
listed above or in lines 9-12
below (attach an itemized list)
8 Total of lines 1 through 7
9 Gross receipts from admissions,
merchandise sold or services
performed, or furnishing of
facilities in any activity that is
related to your exempt
purposes (attach itemized list)
10 Total of lines 8 and 9
11 Net gain or loss on sale of
capital assets (attach
schedule and see instructions)

-

13 Total Revenue
Add lines 10 through 12
14 Fundraising expenses
15 Contributions, gifts, grants,
and similar amounts paid out
(attach an itemized list)

F.
CL

75,000,000
0
0

(d) From------------(e) Provide Total for
(a) through (d)
To ............

100,000,000
0
0

01
01

0
0

0

0

0
000

-
000

0
75.000.000

100

0
000

0
75,000,000

1

0
0

0

0

000

75,000,000

0

1

O

50,000,000

100,0 000

16 Disbursements to or for the
benefit of members (attach an
itemized list)
17 Compensation of officers,
directors, and trustees
18 Other salaries and wages
19 Interest expense
20 Occupancy (rent, utilities, etc.)
21 Depreciation and depletion
22 Professional fees

(c) From.
To

?Pi.1.

0
000

0
0

000
0

0
O
01
0
160,000
0
788,000

125,000
6.004.4531

0

240,000

0

853,000

23 Any expense not otherwise
classified, such as program
services (attach itemized list)

1,565,816

3,639,996

24 Total Expenses
Add lines 14 throuah 23

0,292,906

60,862,449

a
1 000
10.0 378
0
000
0
917

5 7
117
Form 1023 (Rev. 6-2006)

Name: StudentsFirst Initiative
Financial Data


B. Balance Sheet
jr most

Form 1023 (Rev. 6-2006)

EIN:

27 - 3659685

tax

Page

10

2011
(Whole dollars)
Assets

1 Cash................................
$1,305,476

2 Accounts receivable, net .........................
0

3 Inventories ..............................
0
4 Bonds and notes receivable (attach an itemized list) ................
0
5 Corporate stocks (attach an itemized list)
0

6 Loans receivable (attach an itemized list) ....................
0

7 Other investments (attach an itemized list) ...................
0
8 Depreciable and depletable assets (attach an itemized list) ..............
0

9 Land................................
0

10 Other assets (attach an itemized list) .....................
0

11
Total Assets (add lines 1 through 10) .................
1,305,476
-
Liabilities
12 Accounts payable
0

13 Contributions, gifts, grants, etc. payable .....................
0
14 Mortgages and notes payable (attach an itemized list)
0
L
15 Other liabilities (attach an itemized list)
0

16
Total Liabilities (add lines 12 through 15)
0
Fund Balances or Net Assets
17
Total fund balances or net assets ......................
1,305,4760

18
Total Liabilities and Fund Balances or Net Assets (add lines 16 and 17) .....
1,305,4760
19 Have there been any substantial changes in your assets or liabilities since the end of the period
DYes 21 No
shown above? If "Yes," explain.
I14 Public Charity Status
Part X is, designed to classify you as an organization that is either a private foundation or a public charity. Public charity status
is a more favorable tax status than private foundation status. If you are a private foundation, Part X is designed to further
determine whether you are a private operating foundation. (See instructions.)
la Are you a private foundation? If "Yes," go to line lb. If "No," go to line 5 and proceed as instructed.
If you are unsure, see the instructions.

Year End:

LI Yes

b As a private foundation, section 508(e) requires special provisions in your organizing document in
addition to those that apply to all organizations described in section 501(c)(3). Check the box to
confirm that your organizing document meets this requirement, whether by express provision or by
reliance on operation of state law. Attach a statement that describes specifically where your
organizing document meets this requirement, such as a reference to a particular article or section in
your organizing document or by operation of state law. See the instructions, including Appendix B,
for information about the special provisions that need to be contained in your organizing document.
Go to line 2.

171 No
0

2 Are you a private operating foundation? To be a private operating foundation you must engage
directly in the active conduct of charitable, religious, educational, and similar activities, as opposed
to indirectly carrying out these activities by providing grants to individuals or other organizations. If
"Yes," go to line 3. If "No," go to the signature section of Part Xl.

0 Yes

0 No

3 Have you existed for one or more years? If "Yes," attach financial information showing that you are a private
operating foundation; go to the signature section of Part A. If "No," continue to line 4.

0 Yes

0 No

4 Have you attached either (1) an affidavit or opinion of counsel, (including a written affidavit or opinion 0 Yes
from a certified public accountant or accounting firm with expertise regarding this tax law matter),
that sets forth facts concerning your operations and support to demonstrate that you are likely to
satisfy the requirements to be classified as a private operating foundation; or (2) a statement
describing your proposed operations as a private operating foundation?

0 No

5 If you answered "No" to line 1 a, indicate the type of public charity status you are requesting by checking one of the choices below.
You may check only one box.
The organization is not a private foundation because it is:
a 509(a)(1) and 1 70(b)(l)(A)O)—a church or a convention or association of churches. Complete and attach Schedule A.
b 509(a)(1) and 170(b)(1)(A)ii)—a school. Complete and attach Schedule B.
c 509(a)(1) and 170(b)(1)(A)(iii)—a hospital, a cooperative hospital service organization, or a medical research
organization operated in conjunction with a hospital. Complete and attach Schedule C.

0
0
0

ci 509(a)(3)—an organization supporting either one or more organizations described in line 5a through c, f, g, or h
or a publicly supported section 501 (c)(4), (5), or (6) organization. Complete and attach Schedule D.

0

Form

1023

(Rev. 6.2006)

Form 1023 (Rev. 6-2006)

17 gM
.

Name: StudentsFirst

Initiative

FIN:

27 -3659685

Page

11

Public Charity Status (Continued)

0
0
I1
0

e 509(a)(4)—an organization organized and operated exclusively for testing for public safety.
f 509(a)(1) and 170(b)(1)(A)(iv)—an organization operated for the benefit of a college or university that is owned or
operated by a governmental unit.
g 509(a)(1) and 1 70(b)(1)(A)(vi)—an organization that receives a substantial part of its financial support in the form
of contributions from publicly supported organizations, from a governmental unit, or from the general public.
h 509(a)(2)—an organization that normally receives not more than one-third of its financial support from gross
investment income and receives more than one-third of its financial support from contributions, membership
fees, and gross receipts from activities related to its exempt functions (subject to certain exceptions).
i A publicly supported organization, but unsure if it is described in 5g or 5h. The organization would like the IRS to
decide the correct status.
6 If y hecked box *g, h, or i in question 5 above, you must request either an adv/
or a definitive ruling by
sole
one of the boxes below. Refer to the instructions to determine which typuling you are eligible to
ive.

0
0

a Reque
Advance Ruling: By checking this box and signing the consent,uant to section 65
(4) of
the Code
equest an advance ruling and agree to extend the statute of lins on the asse
nt of
excise tax
section 4940 of the Code. The tax will apply only if you do ntablish public
rt status
at the end of
-year advance ruling period. The assessment period will bended forth

",hd
dvance ruling
years to 8 year
onths, and 15 days beyond the end of the first year. Yoe the righ
efuse or limit
the extension to
ally agreed-upon period of time or issue(s). Publicatio5, Exte
g the Tax
Assessment Period,
Odes a more detailed explanation of your rights and tnse
es of the choices
you make. You may o
Publication 1035 free of charge from the IRS webt
.irs.gov or by calling
toll-free 1-800-829-3676.
ing this consent will not deprive you of any appto which you would
otherwise be entitled. If yo
e not to extend the statute of limitations, yoot eligible for an advance
ruling.
e internal Re

For Organization

(Signature of Officer. Director, Trustee, or other
authorized official)

print name of signer)

(Date)

For IRS Use Only

IRS Director, Exempt Organizations

(Date)

0

b Request for Definitive Ru
Check this box if you have completed one tax ye
at least 8 full months and
e ruling. To confirm your public support status, answe
6b(i) if you checked box
you are requesting a de
me 6b(iQ if you checked box h in line 5 above. If you check
ox i in line 5 above,
g in line 5 above. Ans
nd (ii).
answer both lines 6
me 8, column (e) on Part IX-A. Statement of Revenues and Expenses.
(i) (a) Enter 2°!
(b) Attac
t showing the name and amount contributed by each person, company, or
gift
aled more than the 2% amoUnt. If the answer is "None," check this box.

ization whose

ach year amounts are included on lines 1, 2, and 9 of Part IX-A. Statement of RevenueLlillft
penses, attach a list showing the name of and amount received from each disqualified pers
answer is "None," check this box.

0

(ii) (a) F

the

(b) For each year amounts are included on line 9 of Part IX-A. Statement of Revenues and Expenses,
a list showing the name of and amount received from each payer, other than a disqualified person,
payments were more than the larger of (1) 1% of line 10, Part IX-A. Statement of Revenues and
Expenses, or (2) $5,000. If the answer is "None," check this box.
7 Did you receive any unusual grants during any of the years shown on Part IX-A. Statement of
Revenues and Expenses? If "Yes," attach a list including the name of the contributor, the date and
amount of the grant, a brief description of the grant, and explain why it is unusual.

0

0 Yes
Form

0

1023

No

(Rev. 6-2006)

Form 1023 (Rev. 6-2006)
Name: StudentsFlrst Initiative
IIJp4I User Fee Information

SIN:

27 - 3659685

Page

12

You must include a user fee payment with this application. It will not be processed without your paid user fee. If your average
annual grass receipts have exceeded or will exceed $10,000 annually over a 4-year period, you must submit payment of $750. If
your gross receipts have not exceeded or will not exceed $10,000 annually over a 4-year period, the required user fee payment
is $300. See instructions for Part XI, for a definition of gross receipts over a 4-year period. Your check or money order must be
made payable to the United States Treasury. User fees are subject to change. Check our website at w'w.irs.gov and type "User
Fee" in the keyword box, or ca// Customer Account SeMces at 1-877-829-5500 for current information.

0

1 Have your annual gross receipts averaged or are they expected to average not more than $10,0007
Yes
ZJ No
If "Yes," check the box on line 2 and enclose a user lee payment of $300 (Subject to change—see above).
If "No." check the box on line 3 and enclose a user tee oavment of $750 iSubiect to chanae—see
above).
2 Check the box it you have enclosed the
3 Check the box If you have enclosed the
thia appIloaUcq on behalf of the above organizalfon and that I have examined Thu
I declare under the penaitlea of piijoy that I e
application. tnchdbg the e000mp(nYIng ne5uIesj

r

pdto the beat of my knowledge It Is iwo, correct, and complete.

Please........helie Rhea
(Type Or pdnt name or signal
of OffIcer, 0recto. Truslee. or other
Here "
authorized officla
President

(Date)

i1!L.

(Type or P1w title or authoihy of signer)

Reminder: Send the completed Form 1023 Checklist with your filled-in-application.

10flfl

1023

(Rev. 6-2006)

STUDENTSFIRST INSTITUTE
CONFLICT OF INTEREST POLICY

A.

Purpose

The purpose of the conflict of interest policy is to protect the interest of the
Corporation when it is contemplating entering into a transaction or arrangement that
might benefit the private interest of an officer or director of the Corporation or might
result in a possible excess benefit transaction. This policy is intended to supplement
but not replace any applicable state and federal laws governing conflict of interest
applicable to nonprofit and charitable organizations.
B.

Definitions
1.

Interested Person

Any director, principal officer, or member of a committee with governing
board delegated powers, who has a direct or indirect financial interest, as defined
below, is an interested person.
2.

Financial Interest

A person has a financial interest if the person has, directly or indirectly,
through business, investment, or family:

74776-0001/LEGAL20089300.1

-12-

a.

An ownership or investment interest in any entity with which the
Corporation has a transaction or arrangement,

b.

A compensation arrangement with the Corporation or with any entity
or individual with which the Corporation has a transaction or
arrangement, or

C.

A potential ownership or investment interest in, or compensation
arrangement with, any entity or individual with which the Corporation
is negotiating a transaction or arrangement.

Compensation includes direct and indirect remuneration as well as gifts or
favors that are not insubstantial.
A financial interest is not necessarily a conflict of interest. Under procedures
outlined below, a person who has a financial interest may have a conflict of interest
only if the appropriate governing board or committee decides that a conflict of interest
exists.
C.

Procedures
1.

Duty to Disclose

In connection with any actual or possible conflict of interest, an interested
person must disclose the existence of the financial interest and be given the
opportunity to disclose all material facts to the directors and members of committees
with governing board delegated powers considering the proposed transaction or
arrangement.
2.

Determining Whether a Conflict of Interest Exists

After disclosure of the financial interest and all material facts, and after any
discussion with the interested person, he/she shall leave the governing board or
committee meeting while the determination of a conflict of interest is discussed and
voted upon. The remaining board or committee members shall decide if a conflict of
interest exists.

74776-0001 /LEGAL20089300. I

13

3.

D.

E.

Procedures for Addressing the Conflict of Interest
a.

An interested person may make a presentation at the governing board
or committee meeting, but after the presentation, he/she shall leave the
meeting during the discussion of, and the vote on, the transaction or
arrangement involving the possible conflict of interest.

b.

The chairperson of the governing board or committee shall, if
appropriate, appoint a disinterested person or committee to investigate
alternatives to the proposed transaction or arrangement.

C.

After exercising due diligence, the governing board or committee shall
determine whether the Corporation can obtain with reasonable efforts a
more advantageous transaction or arrangement from a person or entity
that would not give rise to a conflict of interest.

d.

If a more advantageous transaction or arrangement is not reasonably
possible under circumstances not producing a conflict of interest, the
governing board or committee shall determine by a majority vote of
the disinterested directors whether the transaction or arrangement is in
the Corporation's best interest, for its own benefit, and whether it is
fair and reasonable. In conformity with the above determination, it
shall make its decision as to whether to enter into the transaction or
arrangement.

Violations of the Conflicts of Interest Policy
1.

If the governing board or committee has reasonable cause to believe a member
has failed to disclose actual or possible conflicts of interest, it shall inform the
member of the basis for such belief and afford the member an opportunity to
explain the alleged failure to disclose.

2.

If, after hearing the member's response and after making further investigation
as warranted by the circumstances, the governing board or committee
determines the member has failed to disclose an actual or possible conflict of
interest, it shall take appropriate disciplinary and corrective action.

Records of Proceedings

The minutes of the governing board and all committees with board delegated
powers shall contain:

74776-0001/LEGAL20089300.1

-14.

F.

G.

1.

The names of the persons who disclosed or otherwise were found to have a
financial interest in connection with an actual or possible conflict of interest,
the nature of the financial interest, any action taken to determine whether a
conflict of interest was present, and the governing board's or committee's
decision as to whether a conflict of interest in fact existed.

2.

The names of the persons who were present for discussions and votes relating
to the transaction or arrangement, the content of the discussion, including any
alternatives to the proposed transaction or arrangement, and a record of any
votes taken in connection with the proceedings.

Compensation
1.

A voting member of the governing board who receives compensation, directly
or indirectly, from the Corporation for services is precluded from voting on
matters pertaining to that member's compensation.

2.

A voting member of any committee whose jurisdiction includes compensation
matters and who receives compensation, directly or indirectly, from the
Corporation for services is precluded from voting on matters pertaining to that
member's compensation.

3.

No voting member of the governing board or any committee whose
jurisdiction includes compensation matters and who receives compensation,
directly or indirectly, from the Corporation, either individually or collectively,
is prohibited from providing information to any committee regarding
compensation.

Annual Statements

Each director, principal officer and member of a committee with governing
board delegated powers shall annually sign a statement which affirms such person:

74776-0001/LE0AL20089300.1

-15-

H.

1.

Has received a copy of the conflicts of interest policy,

2.

Has read and understands the policy,

3.

Has agreed to comply with the policy, and

4.

Understands the Corporation is charitable and in order to maintain its federal
tax exemption it must engage primarily in activities which accomplish one or
more of its tax-exempt purposes.

Periodic Reviews

To ensure the Corporation operates in a manner consistent with charitable
purposes and does not engage in activities that could jeopardize its tax-exempt status,
periodic reviews shall be conducted. The periodic reviews shall, at a minimum,
include the following subjects:

I.

1.

Whether compensation arrangements and benefits are reasonable, based on
competent survey information and the result of arm's length bargaining.

2.

Whether partnerships, joint ventures, and arrangements with management
organizations conform to the Corporation's written policies, are properly
recorded, reflect reasonable investment or payments for goods and services,
further charitable purposes and do not result in inurement, impermissible
private benefit or in an excess benefit transaction.

Use of Outside Experts

When conducting the periodic reviews as provided for in this policy, the
Corporation may, but need not, use outside advisors. If outside experts are used, their
use shall not relieve the governing board of its responsibility for ensuring periodic
reviews are conducted.

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StudentsFirst Institute
Form 1023 Attachments
EN 27-3659685

Form 1023 Attachments
Part IV: Narrative Description of Activities
StudentsFirst Institute (SF1) is committed to researching and developing model policies that
protect the interests of children in American public education through transformative education
reform. Identifying and rewarding excellent teachers, giving newer teachers the necessary
training, educating governmental and school officials as to the most effective use of public
dollars for implementing education reform, and improving or removing ineffective educators in
an expeditious manner while respecting due process are just a few of the necessary components
that comprise our recommendations. Every family deserves a choice of excellent schools to
attend; getting into a great school should be a right of every child, and should never fall to
chance. All of our citizens need to understand that our schools are not only an anchor for our
communities, but an absolute gateway to our national prosperity and competitive standing in the
world economy.
1.

Introduction

The crisis in American education is unambiguous. The United States spends $600 billion every
year on our public schools, which educate nearly 90% of the country's children, but we are not
getting results. Schools in the U.S. fail to create social mobility: on average, students' life
outcomes are still determined too much by their parents' backgrounds. We also lag other
countries: of 30 the industrialized countries regularly surveyed, U.S. schools rank near the
bottom and are not getting better. This translates into an economic loss of over $2 trillion per
year, and the problem is getting worse as other countries get better.
Whether we are a just and prosperous society in 20-30 years depends upon whether we have the
courage and conviction necessary to make radical changes today. We know that specific reforms
that can turn around our schools. That is clear from the experience of other countries, which
have turned around their schools. The evidence here in the US proves that great teachers,
empowered parents, and responsible leadership can deliver great results for all children. We also
know that the time is ripe for change. The groundwork has been laid by the efforts of teachers,
parents, and reformers all over the country. Many great organizations are pushing to turn around
our schools, and there's a national demand for change.
SF1 will be a national, comprehensive, and uncompromising national movement to build upon,
connect, and accelerate reforms that defend the interests of America's students. Specifically, the
organization will articulate a gold standard for education reform, based on the best evidence as to
what works in teacher professionalism, student choice, and system-wide accountability. We will
provide tools and services to local leaders who want to implement local change and we will build
a membership movement with a national voice. We will deploy resources to defend students'
interests with litigation, mobilization, and advocacy.
SFI's organizational culture flows from a refusal to compromise on our commitment to students.
We operate in a fast-paced environment with minimal overhead. We expect all of our
professionals to thrive in conditions of uncertainty, frequent feedback, and rapid change. We
focus on accountability for results, and therefore expect an orientation toward action. Our

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Form 1023 Attachments
BIN 27-3 659685

national scale requires us to work virtually and with diverse partners, but our shared mission
builds deep loyalty and sense of team.
2.

Projects
a.

Think Tank for Educational Reform

SF1 will be organized and operated to generate ideas and educate the public. We anticipate that
this will cover as much as 25% of our ongoing employee costs. This includes time and money
spent to:
. Review and develop cutting-edge research with respect to education reform.
• Coordinate with other education reform groups to discuss common areas of strategy and
platforms on which to base broad policy initiatives.
• Develop an overall policy agenda reflecting the best practices for education reform.
• Educate the public about education reform issues through online "explainer" content such
as motion graphics, video clips, and blogs, andalso through general grassroots organizing
and outreach provided that the outreach does not, in substantial part, qualify as legislative
lobbying.
• Responding to written requests for information and assistance from legislative
committees.
• Establish communication lines with leading experts in education reform to ensure SF1 has
the most up-to-date information on new models of education reform.
b.

Training & Grants

SF1 will work with foundations and other donors to provide grants to support the
professionalization of teaching, typically in the form of grants that would be tied to specific
contractual changes that would move toward merit-based evaluation and retention systems.
Generally, school districts have set budgets based on the contracts with the teachers unions.
Therefore, in many instances they are unable to provide additional incentives such as merit-based
pay increases.
SF1 also envisions providing grants to public school districts to provide merit-based incentives or
other reforms that positively impact children's education. The grants will be available to school
districts and/or states that have implemented substantial education reform measures of which just
one component is merit-based incentives, with a structure and goal similar to the "Race to the
Top" federal grants, except with students even more of a top priority.

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a.

Litigation

SF1 may sponsor or aid litigation to defend civil rights in the field of education. SF1 will only
engage in litigation where the litigation will have a substantial impact beyond the interest of the
litigants. SF1 will not engage in litigation when the primary source of financial support of the
organization is from the persons being represented, or under circumstances where a donor may
claim, directly or indirectly, a charitable deduction for the cost of litigation that serves the
donor's private benefit.
Total expenditures on litigation support will likely be low as we expect pro bono support from
law firms and other partnerships on these efforts. SF1 may also file amicus curiae briefs where
appropriate.
b.

Public Awareness

SF1 will strive to ensure that education reform is in the public eye and the public's
consciousness. SF1 understands the need to have a sophisticated marketing and public relations
plan and team in place to most effectively convey the critical nature of education reform in this
country. Current issues such as ("Last in, First out") LIFO are critically important and raising
public awareness is one of our critical missions. There are other issues such as merit pay which
will also be part of the overall policy recommendations for education reform by SF1. There are
several options under consideration. One idea would be to create a national fund that would be
available to school districts that want to radically reform their teaching professionalism. This
would akin to the federal "Race to the Top" grants, except modified to make students even more
of a top priority for awarding grants. Another idea would be to go to districts that seemed
promising, and offer them a grant conditional on making substantive reform efforts. The notion
of the grant going directly to teachers for merit pay is unlikely, but SF1 would not rule it out
completely if it furthers the cause of education reform.
Public awareness campaigns will be conducted in accordance with the lobbying restrictions, as
addressed more fully in Part VIII, #2a.
Part V, #2a
Mr. Coleman is a founder of Student Achievement Partners, an organization which assembles
leading thinkers and researchers to design actions to substantially improve student achievement.
Ms. KincIall is an employee of Student Achievement Partners. SF1 has no relationship with
Student Achievement Partners, and will not hire or compensate it.
Part V, #3a: Biographies & Duties
Michelle Rhee: President I Director
a.

Biography

Michelle Rhee has been working for the last 18 years to give children the skills and knowledge
they will need to compete in a changing world. From adding instructional time after school and

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Form 1023 Attachments
E1N 27-3659685

visiting students' homes as a third grade teacher in Baltimore, to hosting hundreds of community
meetings and creating a Youth Cabinet to bring students' voices into reforming the DC Public
Schools, she has always been guided by one core principle: put students first.
Each chapter of Michelle's story has convinced her: students of every background and ZIP code
can achieve at high levels, and for our schools to become what children deserve, every educator
is called to believe this. Even in the toughest of circumstances, all teachers are called to turn the
incredible potential that fills their classrooms daily, into the achievements worthy of our children
and country.
Teaching with Teach for America
As a Teach for America (TFA) corps member in a Harlem Park Community School in Baltimore
City, through her own trial and error in the classroom, she gained a tremendous respect for the
hard work that teachers do every day. She also learned the lesson that would drive her mission
for years to come: teachers are the most powerful driving force behind student achievement in•
our schools.
Bringing Excellent Teachers to Classrooms across America - TNTP
In 4997 Ms. Rhee founded The New Teacher Project (TNTP) to bring more excellent teachers to
classrooms across the country. Under her leadership TNTP became a leading organization in
understanding and developing innovative solutions to the challenges of new teacher hiring. As
Chief Executive Officer and President, Ms. Rhee partnered with school districts, state education
agencies, non-profit organizations and unions to transform the way schools and other
organizations recruit, select and train highly qualified teachers in difficult-to-staff schools.
Her work with TNTP implemented widespread reform in teacher hiring practices, improving
teacher hiring in Atlanta, Baltimore, Chicago, Miami, New York, Oakland and Philadelphia.
TNTP placed 23,000 new, high-quality teachers in these schools across the country.
Driving Unprecedented Growth in the D.C. Public Schools
On June 12, 2007, Mayor Adrian Fenty appointed Chancellor Rhee to lead the District of
Columbia Public Schools (DCPS), a school district serving more than 47,000 students in 123
schools. Under her leadership, the worst performing school district in the country became the
only major city system to see double-digit growth in both their state reading and state math
scores in seventh, eighth and tenth grades over three years.
The graduation rate rose, and after steep declines enrollment rose for the first time in forty years.
In her last year as chancellor, every eligible DC public school attracted applicants for the annual
K-12 Out-of-Boundary, preschool, and pre-Kindergarten (pre-K) lotteries. Fourteen schools had
waitlists for the first time. Ultimately, a record high of 5,219 families, representing an increase of
50 percent over 2009, expressed interest in DCPS programs located in all eight wards.

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Form 1023 Attachments
Efl'I 27-3659685

Collaborating with Pioneers
Michelle Rhee currently serves on the Advisory Boards for the National Council on Teacher
Quality, the National Center for Alternative Certification, and Project REACH of the University
of Phoenix's School of Education.
Education
Ms. Rhee has a bachelor's degree in government from Cornell University and a master's in public
policy from Harvard University's Kennedy School of Government.
b.

Duties

Ms. Rhee spends approximately 50 hours a week on her duties. The President shall, subject to
the Board's control, supervise control of all of the assets, business and affairs of the organization.
The President shall preside over meetings of the Board. The President may sign deeds,
mortgages, bonds, contracts, or other instruments, except when the signing and execution thereof
have been expressly delegated by the Board or by these Bylaws to some other officer or agent of
the organization or are required by law to be otherwise signed or executed by some other officer
or in some other manner. In general, the President shall perform all duties incident to the office
of President and such other duties as are assigned to her by the Board from time to time.
Ann-Margaret Kindall: Secretary I Director
a.

Biography

Ann-Margaret Michael is the Operations Manager of Student Achievement Partners, an
organization that works to design actions to substantially improve student achievement. AnnMargaret Michael's career has consisted of both conference planning and high level Executive
assistant positions in large organizations such as American Express, EDS and First American. In
2005 she joined McGraw-Hill as David Coleman's Executive Assistant. After a two year tenure
she left McGraw-Hill with David to start up Student Achievement Partners.
b.

Duties

Ms. Kindall spends approximately 1 hour a week on her duties. She shall attend meetings of the
Board of Directors, and perform all duties incident to the office of Treasurer and such other
duties prescribed by the Board from time to time.
David Coleman: Treasurer / Director
a.

Biography

David Coleman is a proven education innovator. He runs Student Achievement Partners, which
works with foundations, school districts, and leading thinkers to drive actions that improve
student achievement. Previously, he founded the Grow Network, the nation's leader in
assessment reporting and customized instructional materials. Before that, he served education

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Form 1023 Attachments
EIN 27-3659685

and other clients as a consultant at McKinsey & Company. He is a Rhodes Scholar and
graduate of Yale, Oxford, and Cambridge.
b.

Duties

Mr. Coleman spends approximately 1-hour a week on his duties. The Treasurer shall have
charge and custody of and be responsible for all funds and securities of the organization; receive
and give receipts for moneys due and payable to the organization from any source whatsoever,
and deposit all such moneys in the name of the organization in banks, trust companies or other
depositories selected in accordance with the provisions of these Bylaws; and in general perform
all of the duties incident to the office of Treasurer and such other duties as from time to time may
be assigned to him by the President or the Board. He shall attend meetings of the Board of
Directors, and perform all duties as prescribed by the Board from time to time.
Jason Zimba: Director
a.

Biography

Jason Zimba is a co-founder of Student Achievement Partners, an organization that designs
policy actions for raising student achievement. As a member of the writing team for the Common
Core State Standards for Mathematics, Jason was instrumental in reaching a new state of the art
for internationally benchmarked, college- and career-ready standards based on evidence. Jason
was also a co-founder of The Grow Network, an education technology company that helps state
and district school systems use assessment to inform instruction. Grow Network was acquired
by McGraw-Hill in 2004.
b.

Duties

Mr. Zimba spends approximately 1 hours a week on his duties. He shall attend meetings of the
Board of Directors, and perform all duties as prescribed by the Board from time to time.
Dmitri Mehihorn
a.

Biography

Dmitri Mehihorn has an established track record of change management. He is on leave from
Gerson Lehrman Group, a leading provider of compliance solutions and consulting services,
where he manages 375 professionals across 19 offices. Previously, he was Chief of Staff to the
Chairman of O'Melveny & Myers, an $800 million law firm. Before that, he was at McKinsey
& Company. Dmitri earned his undergraduate degree from Stanford, his masters from Harvard,
and his law degree from Yale.
b.

Duties

Mr. Mehlhorn spends approximately 40 hours a week on his duties. He shall perform all duties
as Chief Operating -Officer and other duties as prescribed by the President.

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Mafara Hobson
a.

Biography

Mafara Hobson has enjoyed more than 10 years of hands-on experience in the field of public
relations and communications since graduating from Howard University's School of
Communications. She mostly recently served as the communications director for Washington,
DC Mayor Adrian M. Fenty, where she worked closely with Michelle Rhee during the onset of
DC's historic education initiative.
b.

Duties

Ms. Hobson approximately 40 hours a week on her duties. She shall perform all duties as Press
Secretary and other duties as prescribed by the President.
Kathleen deLaski
C.

Biography

Kathleen M. deLaski was the Senior Program Officer for Education for the Walton Family
Foundation, which funds efforts to improve education quality in urban school districts
nationwide. Formerly, Ms. deLaski was president of Sallie Mae's philanthropic arm, a nonprofit
established to help open the doors of higher education for low income and minority families. She
first joined Sallie Mae in 2001 as Senior Vice President and Chief Communications Officer. In
this capacity, her responsibilities ranged from government and industry relations to consumer
marketing and investor relations. Ms. deLaski earned her undergraduate degree in Political
Science and English at Duke University and her master's degree in Public Administration at
Harvard University's J.F. Kennedy School of Government.
d.

Duties

Ms. deLaski approximately 40 hours a week on her duties. She shall perform all duties as Editor
in Chief and other duties as prescribed by the President.
Kate Gottfredson
a.

Biography

Kate Gottfredson has enjoyed over 10 years of experience working directly with local, state and
federal leaders to develop and implement reform minded policy agendas. Most recently, Kate
secured legislative victories to advance aggressive public education reform in the District of
Columbia as the Senior Policy Advisor and Program Manager for Education to Mayor Adrian M.
Fenty and later as as the Deputy Chief of Staff to Michelle A. Rhee at the D.C. Public Schools.
Kate earned her undergraduate degree from the University of California at Davis and law degree
from the University of Arizona.

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Form 1023 Attachments
E11'1 27-3659685

b.

Duties

Ms. Gottfredson approximately 40 hours a week on her duties. She shall perform all duties as
Vice President of Policy and other duties as prescribed by the President.
Bridget Davis
a.

Biography

Ms. Davis has served in the Executive Office of Mayor Adrian M. Fenty as the Director of the
Office of Policy & Legislative Affairs, where she successfully led the passage of Washington
DC's groundbreaking teacher's contract and guided DC Council passage of the Jacks-Fogle
legislation. Before being tapped to lead the Office of Policy & Legislative Affairs, Ms. Davis
was the Director for the Office of Boards and Commissions, where she recruited candidates for
mayoral appointment to more than 180 boards and commissions. Previously, she served as
Community Services Representative for the Mayor's Office of Community Relations & Services.
Ms. Davis' earlier positions included as a Campaign Manager and as a Senior
Account Manager for LSG Strategies and Services, Inc. Ms. Davis holds a Bachelor of Arts
degree in Political Science and Women's Studies from Ohio State University (2001).
b.

Duties

Ms. Davis approximately 40 hours a week on-her duties. She shall perform all duties as
Research Director and other duties as prescribed by the President.
Blue State Digital
Blue State Digital ("BSD") is a leader in online fundraising, advocacy, social networking, and
constituency development programs for nonprofit organizations and corporations. Since its
founding in 2004, BSD has delivered successfully on the promise of the Internet to more than
200 satisfied clients, including Wal-Mart Watch, the Alliance for Climate Protection, and the
Communications Workers of America, raising more than $800 million in contributions to date
and generating tens of millions of online signups and actions. Their programs rest on the
foundation of the BSD Online Tools, a carefully architected technology suite that integrates tools
for fundraising, advocacy, social networking, constituency development, and content
management through a unified interface. Along with their technology services, they provide
comprehensive web design and development services.
SKDKnickerbocker
SKDKnickerbocker ("SKD") is a public relations/communications firm that provides strategic
advice, public relations, television ads, direct mail and research. The firm specializes in
seamlessly integrating all of these services into one, highly-effective offering. The challenges of
framing a client's narrative and breaking through the 24/7 clutter have never been greater.
Navigating the rapidly changing world of traditional and new media to produce smart and
effective strategic communications is SKD's specialty. From strategic consulting to public

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Form 1023 Attachments
EN 27-3659685

activities or grants to promote lobbying activities will be tracked to ensure that they are no more
than an insubstantial part of SFI's activities.
Part VIII, #4: Fundraising
The President will generally meet in person with donors both at her request and at theirs to
discuss donor contribiItions to SF1. In the future it is possible that direct mail, phone solicitation,
and the intemet/website will be utilized for fundraising purposes as well. In addition, it is
possible that SF1 will hire a fundraising employee.
SFI's fundraising is not focused on a particular state or jurisdiction.
Part VIII, #13: Grants to Organizations
As described in Part IV and Part VI, #lb, the grants will be to either private schools (organized
and operated under section 501(c)(3) of the Code) or to public schools and school districts, to
encourage educational reform by supporting teacher training or merit pay for superior teachers.
SF1 will keep records of all grants made. Once the grant process is established, it will include a
grant proposal process, which will require that a grant agreement be entered into. SF1 will enter
into a grant agreement with each recipient; however, no grants have yet been made, and therefore
no contracts yet exist. The grant agreement will specify the responsibilities of SF1 and the
grantee; restrict the fund for use only for the purposes for which the grant is made; require
periodic written reports from the grantee; and authorize SF1 to withhold or recover grant funds if
they are, or appear to be, misused. The grant agreement will include periodic and final reports
on the use of the funds, and SF1 staff will oversee the use of funds by grantees.
Part VIII, #15: Close Connection
As noted in Part V, line 9, SF1 expects to share some occupancy and staff expenses with
StudentsFirst, Inc., an entity organized under section 501(c)(4) of the Internal Revenue Code.
The two organizations share a common board of directors. The organizations do not expect to
engage in joint program activities.
Part IX, # 15: Grants
These grants will consist of the training and merit grants described in Part W.
Part IX, # 18: Other Salaries and Wages
See the attachment "Salary Chart" for the salary payments budgeted for SF1, and the total amount
of salary budgeted for employees shared between SF1 and its related organizations.
Part IX, #20: Occupancy

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Rent—DC Office

Rent - Sacramento Office

$60,000

$100,000

$126,000

$120,000

$120,000

$120,000

Part IX, #22: Professional Fees

Part IX, #23: Other Expenses
FY "20

^Exptnse

$50,760

$93,060

$139,590

$36,000

$792,000

$1,584,000

Travel

$234,000

$429,000

$643,500

Operational Costs

$625,656

$114,7036

$1,720,554

Research

$125,000

$272,500

$500,000

$14,400

$26,400

$39,600

$480,000

$880,000

$1,320,000

Internet/Phone
Office Equipment

Digital Presence
Marketing

74776-000 MEGA L2OI 15647. 1

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StudentsFirst Institute
Form 1023 Attachments
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Salary Chart
This chart includes the expected SF1 employee positions; their expected hire date; and the
percentage of salary that SF1 expects to pay. Employees with less than 100% of their salary paid
for by SF1, will have a portion of salary paid by StudentsFirst, an affiliated entity organized
under section 501(c)(4) of the Internal Revenue Code.

Title

Salary

SF1 Percentage

SF1 Salary Portion

Correspondence Associate

35000

25% 8750

Correspondence Associate

35000

25% 8750

Graphic Specialist

40000

100% 40000

HR Manager

50000

50% 25000

Teacher Coordinator

100000

25% 25000

VP Policy

125000

75% 93750

Press Secretary

150000

90% 135000

VP Accounting & Finance

150000

50% 75000

VP Organizing

160000

10% 16000

Editor in Chief

180000

95% 171000

VP Development

200000

50% 100000

COO

225000

50% 112500

CEO

300000

50% 150000

35000

75% 26250

225000

90% 202500

Research Associate

35000

75% 26250

Research Associate

35000

75% 26250

Social Media Associate

45000
60000

90% 40500

Research Associate
Chief Implementation Officer

Staff Writer

74776-0001/LEGAL201 15647. 1

100% 60000

Hire
date
Q1
2011
Qi
2011
Qi
2011
Qi
2011
Qi
2011
Qi
2011
Qi
2011
Qi
2011
Qi
2011
Qi
2011
Qi
2011
Qi
2011
Qi
2011
Qi
2012
Qi
2012
Q2
2011
Q2
2011
Q2
2011
Q2

StudentsFirst Institute
Form 1023 Attachments
EN 27-3659685

Staff Writer

60000

100% 60000

Staff Writer

60000

100% 60000

Editor

75000

100% 75000

Editor

75000

100% 75000

Foundation Director

100000

100% 100000

HNW & Planned Giving

150000

50% 75000

VP Talent

150000

50% 75000

VP Technology

150000

50% 75000

CFO

225000

50% 112500

Chief Membership Officer

225000

25% 56250

Chief Mobilization Officer

225000

10% 22500

Chief Policy & Editorial Officer

225000

75% 168750

President

250000

50% 125000

Research Director

125000

90% 112500

Research Associate

35000

75% 26250

Research Associate

35000

75% 26250

Employer Services

40000

25% 10000

Employer Services

40000

25% 10000

Employer Services

40000

25% 10000

Multicultural Services

40000

25% 10000

Multicultural Services

40000

25% 10000

Parent Services

40000

25% 10000

Parent Services

40000

25% 10000

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2011
Q2
2011
Q2
2011
Q2
2011
Q2
2011
Q2
2011
Q2
2011
Q2
2011
Q2
2011
Q2
2011
Q2
2011
Q2
2011
Q2
2011
Q2
2011
Qi
2011
Q3
2011
Q3
2011
Q3
2011
Q3
2011
Q3
2011
Q3
2011
Q3
2011
Q3
2011
Q3
2011

StudentsFirst Institute
Form 1023 Attachments
EIN 27-3659685

Student Services

40000

25% 10000

Student Services

40000

25% 10000

Development Operations

50000

50% 25000

Student Coordinator

50000

25% 12500

Student Coordinator

50000

25% 12500

Corporate Giving Manager

75000

100% 75000

Research Director

75000

75% 56250

Affinity Marketing

100000

25% 25000

Multicultural Coordinator

100000

25% 25000

Multicultural Coordinator

100000

25% 25000

Parent Coordinator

100000

25% 25000

Parent Coordinator

100000

25% 25000

Professional Coordinator

100000

25% 25000

Professional Coordinator

100000

25% 25000

VP Alliances

150000

25% 37500

VP Groups

150000

25% 37500

VP Media

150000

90% 135000

VP Members

180000

25% 45000

Program Officer

125000

90% 112500

Program Officer

125000

90% 112500

Program Officer

125000

90% 112500

Program Officer

125000

90% 112500

Outreach Associate
Outreach Associate

74776-000I/LEGAL20I I 5647. 1

35000
35000

10% 3500
10% 3500

Q3
2011
Q3
2011
Q3
2011
Q3
2011
Q3
2011
Q3
2011
Q3
2011
Q3
2011
Q3
2011
Q3
2011
Q3
2011
Q3
2011
2011
Q3
2011
Q3
2011
Q3
2011
Q3
2011
Q3
2011
Q3
2012
Q3
2012
Q3
2012
Q3
2012
Q4
2011
Q4

StudentsFirst Institute
Form 1023 Attachments
EIN 27-3659685
2011
Outreach Associate

35000

10% 3500

Outreach Associate

35000

10% 3500

Outreach Associate

35000

10% 3500

Press Associate

35000

90% 31500

Research Associate

35000

75% 26250

Grant Writer

40000

75% 30000

HR Associate

40000

50% 20000

Payroll Manager

40000

50% 20000

Student Services

40000

25% 10000

Student Services

40000

25% 10000

Teacher Services

40000

25% 10000

Teacher Services

40000

25% 10000

Teacher Services

40000

25% 10000

Teacher Services

40000

25% 10000

Tech Support

40000

50% 20000

Network Manager

60000

50% 30000

Accounting Manager

75000

50% 37500

Marketing Director

75000

90% 67500

PR Manager

75000

90% 67500

Pro Bono

75000

75% 56250

Speech Writer

75000

90% 67500

Regional Outreach

125000

10% 12500

Regional Outreach

125000

10% 12500

2011
Q4
2011
Q4

74776-0001/LEGAL201 I 5647. 1

2011
Q4
2011
Q4
2011
Q4
2011
Q4
2011
Q4
2011
Q4
2011
Q4
2011
Q4
2011
Q4
2011
Q4
2011
Q4
2011
Q4
2011
Q4
2011
Q4
2011
Q4
2011
Q4
2011
Q4
2011
Q4
2011
Q4
2011
Q4
2011

StudentsFirst Institute
Form 1023 Attachments
EIN 27-3659685

Regional Outreach

125000

10% 12500

Regional Outreach

125000

10% 12500

Regional Outreach

125000

10% 12500

General Counsel

150000

50% 75000

VP Marketing

150000

90% 135000

Local Partners

75000

90% 67500

Local Partners

75000

90% 67500

Local Partners

75000

90% 67500

Local Partners

75000

90% 67500

Local Partners

75000

90% 67500

District Implementation Director

75000

90% 67500

District Implementation Director

75000

90% 67500

District Implementation Director

75000

90% 67500

District Implementation Director

75000

90% 67500

District Implementation Director

75000

90% 67500

Social Media Associate

35000

90% 31500

Social Media Associate

35000

90% 31500

Social Media Associate

35000

90% 31500

Social Media Associate

35000

90% 31500

Social Media Associate

35000

90% 31500

Social Media Associate

35000

90% 31500

Social Media Associate

35000

90% 31500

Entertainment Brand Assoc.
Field Staff

40000
40000

100% 40000
20% 8000

Q4
2011
Q4
2011
Q4
2011
Q4
2011
Q4
2011
Q4
2012
Q4
2012
Q4
2012
Q4
2012
Q4

74776-0001/LEGAL201 15647. 1

2012
Q4
2012
Q4
2012
Q4
2012
Q4
2012
Q4
2012
Qi
2013
Qi
2013
Qi
2013
Qi
2013
Qi
2013
Qi
2013
Qi
2013
Qi
2013
Qi

StudentsFirst Institute
Form 1023 Attachments
EIN 27-3659685
2013
Field Staff

40000

20% 8000

Field Staff

40000

20% 8000

Field Staff•

40000

20% 8000

Field Staff

40000

20% 8000

Field Staff

40000

20% 8000

Field Staff

40000

20% 8000

Field Staff

40000

20% 8000

Field Staff

40000

20% 8000

Field Staff

40000

20% 8000

Field Staff

40000

20% 8000

Field Staff

40000

20% 8000

Field Staff

40000

20% 8000

Field Staff

40000

20% 8000

Field Staff

40000

20% 8000

Field Staff

40000

20% 8000

Field Staff

40000

20% 8000

Field Staff

40000

20% 8000

Field Staff

40000

20% 8000

Field Staff

40000

20% 8000

Field Staff

40000

20% 8000

Field Staff

40000

20% 8000

Field Staff

40000

20% 8000

Field Staff

40000

20% 8000

74776-0001/LEGAL201 15647. 1

Qi
2013
Qi
2013
Qi
2013
Qi
2013
Q1
2013
Qi
2013
Qi.
2013
Qi
2013
Qi
2013
Qi
2013
Qi
2013
Qi
2013
Q1
2013
Qi
2013
Qi
2013
Qi
2013
Q1
2013
Qi
2013
Qi
2013
Qi
2013
Qi
2013
Qi
2013
Q1
2013

SPidentsFirst Institute
Form 1023 Attachments
EIN 27-3659685

Hiring Coordinator

40000

50% 20000

Affinity Marketing Associate

45000

100% 45000

Associate, Leadership Gifts

45000

50% 22500

Data Analyst

45000

50% 22500

Member Services Associate

45000

25% 11250

Member Services Associate

45000

25% 11250

Member Services Associate

45000

25% 11250

Member Services Associate

45000

25% 11250

Member Services Associate

45000

25% 11250

Member Services Associate

45000

25% 11250

Member Services Associate

45000

25% 11250

Member Services Associate

45000

25% 11250

Member Services Associate

45000

25% 11250

Member Services Associate

45000

25% 11250

Member Services Associate

45000

25% 11250

Member Services Associate

45000

25%. 11250

Member Services Associate

45000

25% 11250

Member Services Associate

45000

25% 11250.

Member Services Associate

45000

25% 11250

Member Services Associate

45000

25% 11250

Member Services Associate

45000

25% 11250

Member Services Associate

45000

25% 11250

Member Services Associate
Member Services Associate

45000
45000

25% 11250
25% 11250

74776-0001ILEGAL201 15647. 1

01
2013
Qi
2013
Qi
2013
Qi
2013
Qi
2013
01
2013
Qi
2013
Qi
2013
Qi
2013
Qi
2013
Qi
2013
01
2013
Qi
2013
Qi
2013
Qi
2013
01
2013
Qi
2013
Qi
2013
Qi
2013
Qi
2013
Qi
2013
Qi
2013
Qi
2013
Qi

StudentsFirst Institute
Form 1023 Attachments
EIN 27-3659685

Member Services Associate

45000

25%

11250

Member Services Associate

45000

25%

11250

Member Services Associate

45000

25%

11250

Member Services Associate

45000

25%

11250

Member Services Associate

45000

25%

11250

Member Services Associate

45000

25%

11250

Member Services Associate

45000

25%

11250

Member Services Associate

45000

25%

11250

Speaking Requests

50000

100%

50000

Conference Coordinator

50000

100%

50000

Director, Events

50000

100%

50000

Secretarial

50000

50%

25000

Secretarial

0000

50%

25000

Secretarial

50000

50%

25000

Tech Support

50000

50%

25000

Brand Manager
Director, Knowledge
Management

60000

100%

60000

60000

100%

60000

Manager, Facilities

60000

50%

30000

Manager, Partnerships

60000

50%

30000

Manager, Partnerships

60000

50%

30000

Project Manager

60000

50%

30000

Manager, Foundation Relations

70000

100%

70000

Manager, Major Donors

70000

50%

35000

74776-0001/LEGAL201 15647. 1

2013
Qi
2013
Qi
2013
Qi
2013
Qi
2013
Qi
2013
Qi
2013
Qi
2013
Qi
2013
Qi
2013
Qi
2013
Qi
2013
Qi
2013
Qi
2013
Q1
2013
Qi
2013
Qi
2013
Q1
2013
Qi
2013
Qi
2013
Qi
2013
Qi
2013
Qi
2013
Qi
2013

StudentsFirst Institute
Form 1023 Attachments
EN 27-3659685

Manager, Planned Giving

70000

50%

35000

Accounts Payable

75000

50%

37500

Accounts Receivable

75000

50%

37500

Contract Attorney

75000

50%

37500

Director of Strategy

75000

50%

37500

Director, Curriculum & Pedagogy

75000

100%

75000

Director, Design

75000

50%

37500

Director, Social Media

75000

90%

67500

District Implementation Assoc.

75000

100%

75000

District Implementation Assoc.

75000

100%

75.000

District Implementation Assoc.

75000

100%

75000

District Implementation Assoc.

75000

100%

75000

District Implementation Assoc.

75000

100%

75000

District Implementation Assoc.

75000

100%

75000

District Implementation Assoc.

75000

100%

75000

District Implementation Assoc.

75000

100%

75000

District Implementation Assoc.

75000

100%

75000

District Implementation Assoc.

75000

100%

75000

District Implementation Assoc.

75000

100%

75000

District Implementation Assoc.

75000

100%

75000

District Implementation Assoc.

75000

100%

75000

District Implementation Assoc.

75000

100%

75000

District Implementation Assoc.
District Implementation Assoc.

75000
75000

100%
100%

75000
75000

74776-0001/LEGAL201 15647. 1

Qi
2013
Qi
2013
Qi
2013
Qi
2013
Qi
2013
Qi
2013
Qi
2013
Qi
2013
Qi
2013
Qi
2013
Qi
2013
Qi
2013
Qi
2013
Qi
2013
Qi
2013
Qi
2013
Qi
2013
Qi
2013
Qi
2013
Qi
2013
Qi
2013
Qi
2013
Qi
2013
Qi

StudentsFirst Institute
Form 1023 Attachments
EIN 27-3659685

District Implementation Assoc.

75000

100%

75000

Finance Associate

75000

50%

37500

Intern Manager

75000

50%

37500

Manager, Member Services

75000

25%

18750

Manager, Member Services

75000

25%

18750

Manager, Member Services

75000

25%

18750

Manager, Member Services

75000

25%

18750

Outreach Specialist

75000

10%

7500

Outreach Specialist

75000

10%

7500

Outreach Specialist

75000

10%

7500

Outreach Specialist

75000

10%

7500

Regional Outreach

75000

10%

7500

Regional Outreach

75000

10%

7500

Regional Outreach

75000

10%

7500

Regional Outreach

75000

10%

7500

Technical Lead -- CRM systems

75000

50%

37500

Director, Policy Research

90000

100%

90000

Director, Talent Development

90000

50%

45000

Director, Entertainment Brand

95000

100%

95000

Director, Finance & Operations

95000

50%

47500

International Partnerships

95000

100%

95000

Senior Secretarial

95000

50%

47500

100000

50%

50000

Senior Fellow

74776-0001/LEGAL201 15647. 1

2013
Q1
2013
Qi
2013
Qi
2013
01
2013
Qi
2013
Qi
2013
Qi
2013
01
2013
Qi
2013
01
2013
01
2013
01
2013
01
2013
Qi
2013
Qi
2013
01
2013
Qi
2013
Qi
2013
Qi
2013
Qi
2013
Qi
2013
Qi
2013
Qi
2013

StudentsFirst Institute
Form 1023 Attachments
EIN 27-3659685

Qi
Associate GC - Litigation

74776-000IILEGAL20I 5647. I

125000

50%

62500

2013

wi

COPY OF WITHIN PAPER
RECEIVED

DEC 12 2011
OFFICE OF THE ATTORNEY GE
CHARITIES BUREAU

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