Donor Directed Funds Form Question Title * 1. Date Date: Date Question Title * 2. Name of Donor Name: Company: Address: Address 2: City/Town: State: -- select state -- AL AlabamaAK AlaskaAS American SamoaAZ ArizonaAR ArkansasCA CaliforniaCO ColoradoCT ConnecticutDE DelawareDC District of ColumbiaFM Federated States of MicronesiaFL FloridaGA GeorgiaGU GuamHI HawaiiID IdahoIL IllinoisIN IndianaIA IowaKS KansasKY KentuckyLA LouisianaME MaineMH Marshall IslandsMD MarylandMA MassachusettsMI MichiganMN MinnesotaMS MississippiMO MissouriMT MontanaNE NebraskaNV NevadaNH New HampshireNJ New JerseyNM New MexicoNY New YorkNC North CarolinaND North DakotaMP Northern Mariana IslandsOH OhioOK OklahomaOR OregonPW PalauPA PennsylvaniaPR Puerto RicoRI Rhode IslandSC South CarolinaSD South DakotaTN TennesseeTX TexasUT UtahVT VermontVI Virgin IslandsVA VirginiaWA WashingtonWV West VirginiaWI WisconsinWY Wyoming ZIP: Country: Email Address: Phone Number: Question Title * 3. What amount are you donating to begin your fund? $ Question Title * 4. Will you be encouraging others to donate to your fund? Yes No Question Title * 5. What would you like to name your fund? Question Title * 6. By using each drop down box select the target population that you would like to support. Gender Age Geographic area Income level Target Male Female Both Target Gender menu Below age 18 Above age 18 Both Neither (list your preferred age group in the area marked "OTHER" below) Target Age menu N/A Baltimore City Baltimore County Anne Arundel County None of the above (List the area in area marked "OTHER" below) More than one area (List each area below) None Target Geographic area menu Above U.S. Poverty Guidelines Below U.S. Poverty Guidelines Both Neither (list your preferred income guidelines in the are marked "OTHER" below) Target Income level menu OTHER (list additional demographic and/or geographic guidelines for your target population here) Question Title * 7. What type of project(s) would you like to fund? (Check as many as preferred) Funding the cost of an install of a barber and/or beauty shop to serve your target population Funding the cost of a grooming professional(s) to provide grooming services Fund the cost of a personnel to coordinate grooming services for your target population Fund the cost of grooming supplies and/or equipment Other (List your preferred type of project that you would like to fund in the below section marked "OTHER") OTHER (please specify) Question Title * 8. When would you like to begin publicizing the request for proposal (RFP) for the purposes of soliciting applications for your funds. As soon as I donate the funds and the agreement is signed between the RBCF and myself OTHER (See preferred date in the field below) Prefeered Date to release RFP Question Title * 9. Do you have additional individuals who are authorized to give advice and make decisions on concerning this fund? Please list no more than three authorized individuals complete with contact phone and email below. The Donor may recommend to The RBCF the revocation of any designation in writing via email. Question Title * 10. If you have any additional requirements or comments please express them in the essay box below. Question Title * 11. I am acknowledging distributions from the Fund of the net income or principal or both, shall be made at such times, in such amounts, in such ways, and for such purposes as Rob's Barbershop Community Foundation Board or management (RBCF) shall determine with advice from the Donor or your designee.The Donor may submit recommendations to RBCF with respect to grant distributions. Recommendations with respect to distributions made by the Donor or his/her designee are solely advisory and RBCF is not bound by any such recommendations. Any and all such designations or revocations made by the Donor shall be made in writing and become effective when received by RBCF. Grant recommendations received from the Donor or his/her designee shall be for awards of $0.00 or more. Recommendations for grant distributions shall be forwarded in writing to the Foundation via email.The Fund shall be administered under the guidelines set by the Donor and approved by the (including any amendments) RBCF. It is understood that the Fund shall be charged a one time fee of 18% (unless otherwise negotiated) administrative expenses attributable to its creation of the request for proposal, it's marketing, gathering of solicitations, vetting applications and publicizing the results. It is intended that the Fund be a component part of The Community Foundation and not a separate trust and that nothing in this agreement shall affect the status of Rob's Barbershop Community Foundation as an organization described in Section 501(c)(3) of the Internal Revenue Code. This agreement shall be interpreted to conform to the requirements of the foregoing provisions of the federal tax laws and any regulations issued pursuant thereto. Rob's Barbershop Community Foundation is authorized to amend this Agreement to conform to the provisions of any applicable law or government regulation in order to carry out the purposes of this Fund. YOU WILL BE CONTACTED WITHIN THE NEXT FIVE BUSINESS DAYS TO COMPLETE THE TRANSACTION TO BEGIN YOUR FUND. I agree I disagree Done