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Cover Sheet
You are submitting a cover sheet for the New York City: Care Coordination Fund (Invitation Only) RFP.
* Indicates a required field
Information about Person Completing the Form
Applicant Organization
After entering an EIN, any information we have will display in the fields below. Please review for accuracy and update as needed.
Click here to find your EIN on Guidestar by Candid
DBA or other name your organization may be known as
$ .00
Most Recent Completed Fiscal Year’s Total Organizational Expenses. Whole dollar amounts only, no commas please
To complete the chart below, please just give your best estimate based on the information you currently have easily available.
Staff(#)
Ethnicity Professional Support Board(#)
Arab:
Asian:
Black/African American:
Latinx:
Native American:
White, Non-Hispanic:
Other:
Totals:
Primary Contact Person for the Proposed Project (if other than Paid Staff Head)
Proposed Project Information
$ .00
Whole dollar amounts only, no commas please
Population Served by Proposed Project
Select if more than half (51%) of people to be served are in that age range
Select if more than 75% of people to be served are that gender
Select if more than half (51%) of people to be served are of that ethnicity/race
National Taxonomy of Exempt Entities (NTEE) (required - up to 3 codes) Enter NTEE codes for the Applicant Organization seeking the grant (not the Funds Administrator)
Click here to find your NTEE classifications on Guidestar by Candid

Upload PDF

Please submit the required materials listed in the application instructions. Combine all materials into a single PDF file no more than 25 MB in size. See the application instructions for more information.

Certification

You will receive a PDF of this cover sheet once it is submitted.

The New York Community Trust reserves the right to share information provided on this form during the evaluation of the proposal.

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