UMC Urgent Needs Grant Application Section 1: DemographicsName of organization* Contact Name* First Last Title* Phone*Email* Enter Email Confirm Email We may use this email address for grant award notifications.Mailing Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Did you receive a grant from UMC in 2022?*YesNoAbout your organization* My organization is a current non-profit 501(c)(3) We have a letter of agreement from our 501(c)(3) fiscal agent Please upload a copy of your 501(c)(3) status OR a letter of agreement and 501(c)(3) documentation from your fiscal agent.*Max. file size: 5 MB.Can accept pdf, jpg, gif, and png files onlyEIN number of organization or fiscal agent* My organization works within one or more for the following focus areas:* Food Housing Health & Safety Economic Security Please check all that applyMy organization provides social services aimed at promoting the welfare of others in Knox County and/or Waldo County, Maine* Yes * I understand that United Midcoast Charities funds operations and programming but does not fund capital projects or endowments. Section 2: Urgent Needs Grant ProposalUrgent Needs Grant funds requested:*Please enter a number greater than or equal to 0.Reason for Urgent Needs Grant Request*What will happen to those you serve if this request is not funded? How have you seen this need increase or change due to our current COVID-19 crisis? 1000 characters max (approx 250 words)What will you use this Urgent Needs Grant for?* List how you will spend these funds. No need for sentences or paragraphs.Impact*Briefly tell us how this response aligns with UMC’s focus areas of food, housing, health and safety, and economic security. Is the support you are proposing accessible and appropriate to vulnerable populations, such as: women, children, older adults, medically fragile, communities of color, unemployed/underemployed, or low income people? Does your organization have the capacity and infrastructure in place to meet this need? 1000 characters max (approx 250 words)What other measures are you taking to address this unprecedented need? Other funders contacted? Do you have any organizational reserves to address this need?*700 characters maxCollaboration: are you working with other partners to coordinate this response?* List any collaborations. No need for sentences or paragraphs.Section 3: Required DocumentationORGANIZATION'S FINANCIALS: Please upload a current Balance Sheet AND P&L or Budget vs Actuals report for your organization*Accepted file types: pdf, Max. file size: 5 MB.(Upload PDF only)NameThis field is for validation purposes and should be left unchanged.