Share the Plate Nomination Form Share the Plate Nomination Form Please read this form carefully and fill it out completely. Nominations without proper documentation cannot be considered. Name First Last PhoneEmail Relationship to First Church:MemberPledging FriendName of nominated recipient organization.Mailing Address of Organization.Purpose of organization (Quote from mission statement if possible.)Do you have a relationship with this organization? If so, what?How does the purpose relate to UU principles and values?Geographic area served (e.g., local, regional, state)Is there an immediate financial need for this organization? If so, please explain.What is the organization’s annual operating budget?What are the organization’s sources of income?What percent of operating budget is spent directly on program or direct service?Is this a 501(c)3 organization? If not, indicate its non-profit status.Are there ongoing ways FUSM members and friends could be involved as volunteers with this organization? If so, please specify.Whom should we contact if the organization is chosen as a recipient? (Provide name, phone number, email)Captcha Be sure to read up on our nomination criteria!