Communities-rise.org



Application For Existing Organization Seeking Pro Bono Legal AssistanceEligibility Guidelines:To be eligible for free legal assistance through Communities Rise, your existing organization must demonstrate the following:Has primarily a charitable or community-based purpose;Has 501c3 or 501c4 tax exempt status;Is unable to pay for legal fees without significant impairment of program resources; andSeeks legal assistance on a business or organizational matter. Communities Rise does not provide assistance in finding an attorney for legal issues related to current or expected litigation.PLEASE NOTE: If you are seeking assistance with your startup organization, for example you need assistance seeking 501c3 or 501c4 status, drafting articles of incorporation or filing with the secretary of state, etc, please fill out our Startup Application found on our website.Application Instructions:There are two ways you can apply for Communities Rise services:Email: The completed application and supplemental materials to contact@communities- Post Mail: Mail the application and supplemental materials to Communities Rise at: 3642 33rd Ave S. Suite C4, Seattle, WA. 98144Application Fee:Communities Rise has a non-refundable screening/placement application fee of $100. You may pay the fee: By check made payable to “Communities Rise” and mailed to the address above; orVia electronic invoice from our online payment method (Stripe) with a credit or debit card (a 3% service charge will be added). Contact Information:Name of Organization FORMTEXT ?????Street Address FORMTEXT ?????City FORMTEXT ?????Zip FORMTEXT ?????Telephone FORMTEXT ?????Website FORMTEXT ?????Primary Contact Person FORMTEXT ?????Title FORMTEXT ?????Telephone FORMTEXT ?????Email FORMTEXT ?????Is your organization a current recipient of any of the following grants? Please check all that apply. FORMCHECKBOX King County Best Start for Kids FORMCHECKBOX King County Communities of Oppportunity FORMCHECKBOX Seattle Foundation Neighbor 2 NeighborDo you require an interpreter? If so, what language?What geographic area(s) or region(s) does your organization serve? FORMCHECKBOX Seattle/King County FORMCHECKBOX Greater Puget Sound (including Tacoma, Olympia, Everett, Kitsap Peninsula) FORMCHECKBOX South King County FORMCHECKBOX Western Washington FORMCHECKBOX Eastern Washington FORMCHECKBOX Washington State FORMCHECKBOX Pacific Northwest FORMCHECKBOX Nationwide FORMCHECKBOX International FORMCHECKBOX Olympic Peninsula FORMCHECKBOX List counties: What is your organization's combined annual program and operating budget? FORMCHECKBOX $10,000 or less FORMCHECKBOX $10,001 - $25,000 FORMCHECKBOX $25,001 - $100,000 FORMCHECKBOX $100,001 - $250,000 FORMCHECKBOX $250,001 - $500,000 FORMCHECKBOX Over $500,000Explain in detail why your organization cannot afford to pay for a lawyer now without significant impairment of program resources. ?If your organization has substantial cash reserves or net income, explain why the reserves or net income cannot be used to pay for legal assistance.? If your financial statement shows substantial payments to consultants, please explain. FORMTEXT ?????____________________________________________________________________________________What is your organization’s mission?Who does your organization serve?A. Is your client population primarily from communities of color? Yes / NoB. Is your client population primarily from low-income communities? Yes / NoC. Describe the client population and communities (including communities of color and low income) you will serve:Please summarize your organization’s activities or programs, including dates for when you started providing the activities or programs:Please describe in detail your legal needs. Please also describe if there are any deadlines or if your legal need is time sensitive and why your legal need is time sensitive: FORMTEXT ?????Has your organization engaged an attorney in the last two years? FORMCHECKBOX Yes FORMCHECKBOX No If YES, please provide the following information:1.The attorney or law firm’s name: FORMTEXT ?????2.The general nature of legal services provided: FORMTEXT ?????3.Whether the organization paid for the attorney’s services: FORMTEXT ?????To allow your volunteer attorney to complete a review of potential conflicts-of-interest, please list any affiliates of your organization, and list any individuals or organizations with which your organization has been (in the past two years) or expects to be (in the coming year) involved in litigation, contract negotiations or other legal issues. Please include a list of all relevant creditors. FORMTEXT ?????Please describe any access needs that your organization may need in connection with the delivery of legal services. (e.g., mobility or communication access).Please add additional background information you may think helpful to providing you legal services.(500 words) How did you hear about Communities Rise?Please upload or include the following with your application as Communities Rise cannot screen or place your matter without each of the following documents: FORMCHECKBOX Copy of IRS 501(c)(3) or (c)(4) determination letter; and FORMCHECKBOX List of the names and addresses of the organization’s board of directors. Addresses should be home addresses in order for our volunteer attorneys to verify that they do not represent existing organizations, companies or individuals with interests in conflict with your organization’s officers, directors, and key personnel; and FORMCHECKBOX Recent 990 form or copy of statement of financial condition for the most recently-completed fiscal year. If your organization has an audited financial statement, please include this. If you file a 990N, please include a real profit and loss statement and budget. If more than six months have passed since the end of your last completed fiscal year, please ALSO include the most recent quarterly or year-to-date income/expense report and budget. FORMCHECKBOX Copies of legal documents related to your particular request for legal assistance (e.g., leases, contracts, correspondence, articles of incorporation, bylaws, tax notices, employment handbooks, etc).Consents And AcknowledgmentsWhile we will use our best efforts to protect the confidential nature of your organization’s legal issues, we must disclose some descriptive information provided through this Application to properly place your matter. Unless you inform us in writing otherwise, we also may disclose the name of your organization and the general nature of legal matters referred through Communities Rise in our annual reports, fundraising and outreach materials, and any success stories or articles we may publish about Communities Rise. By your signature below, please acknowledge your consent to such disclosures in any manner that we deem necessary and appropriate.If we determine that your organization is eligible for free legal assistance through Communities Rise, we will use our best efforts to find a volunteer attorney to represent you. We do not know how long it will take to find a volunteer attorney to assist you or if we will be able to do so. Communities Rise itself will not be providing you with legal representation. Communities Rise assumes no responsibility over the representation you do receive or the outcome. Legal services are provided to the organization not to any individual person. Please have this Consent and Acknowledgments Form signed by a board member or it’s designee. If your organization is eligible for free legal services and Communities Rise locates a volunteer attorney for your organization, a board member or its designee must sign the volunteer attorney’s engagement letter. By your signature below, please also acknowledge your understanding of the foregoing description of Communities Rise anization FORMTEXT ?????Board Member SignatureDate FORMTEXT ?????NameTyping your name on this line constitutes a signatureTitle FORMTEXT ????? ................
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