TALA

Organizational Assistance Request Form

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* For existing Non Profit Organizations

Please provide the following contact information:

Name

Title

Organization

Street address

City

State

Zip Code

Work Phone

Home Phone

Cell Phone

Fax No.

E-mail

Describe the nature of your problem:

Date of Incorporation (if applicable):                 (mm/dd/yy)

Date of IRS determination letter (if applicable):  (mm/dd/yy)

Annual Budget:     $            Fiscal Year End    

Describe your organization's purpose and activities:

Have you ever Consulted an Attorney or Accountant for this problem?        Yes No

If "yes," please explain the current status of your relationship with this professional.

Attachment Checklist: Please mail or drop off the following information with your request form:

· Names, titles and addresses of Board of Directors

· A copy of your organizational documents (Articles of Incorporation and Bylaws) OR a brief statement of purpose

· A copy of your IRS determination letter (if received)

· A copy of your budget for the current fiscal year

· Copies of any documents relating to the specific problem for which you are seeking assistance (i.e., contracts, correspondence, etc.)

NOTE: TALA reserves the right to reject a client's application for assistance for a variety of reasons, including: (1) organization's primary purpose not charitable or educational; (2) matter may require too much time to resolve on a volunteer basis; (3) unavailability of volunteer qualified to handle a particular request.

Please print out this form and submit to:

Texas Accountants and Lawyers for the Arts
1540 Sul Ross
Houston, TX 77006

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For Office use ONLY:

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