Attach to Form 990 or Form 990-EZ.
See separate instructions.| (i) Name of supported organization |
(ii) EIN |
(iii) Type of organization (described on lines 1- 9 above or IRC section (see instructions)) |
(iv) Is the organization in col. (i) listed in your governing document? |
(v) Did you notify the organization in col. (i) of your support? |
(vi) Is the organization in col. (i) organized in the U.S.? |
(vii) Amount of support? |
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|---|---|---|---|---|---|---|---|---|---|
| Yes | No | Yes | No | Yes | No | ||||
| Total | |||||||||
| Calendar year(or fiscal year beginning in) | (a) 2006 | (b) 2007 | (c) 2008 | (d) 2009 | (e) 2010 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .... | ||||||
| 2 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf....... | ||||||
| 3 | The value of services or facilities furnished by a governmental unit to the organization without charge.. | ||||||
| 4 | Total. Add lines 1 through 3.. | ||||||
| 5 | The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f).. | ||||||
| 6 | Public Support. Subtract line 5 from line 4. | ||||||
| Calendar year(or fiscal year beginning in) | (a) 2006 | (b) 2007 | (c) 2008 | (d) 2009 | (e) 2010 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | ||||||
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | ||||||
| 9 | Net income from unrelated business activities, whether or not the business is regularly carried on.. | ||||||
| 10 | Other income. (Explain in Part IV.) Do not include gain or loss from the sale of capital assets.. | ||||||
| 11 | Total support (Add lines 7 through 10). | ||||||






| Calendar year(or fiscal year beginning in) | (a) 2006 | (b) 2007 | (c) 2008 | (d) 2009 | (e) 2010 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") . | 2,870 | 9,605 | 230 | 1,850 | 6,895 | 21,450 |
| 2 | Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose...... | 150,831 | 200,066 | 186,223 | 236,297 | 255,547 | 1,028,964 |
| 3 | Gross receipts from activities that are not an unrelated trade or business under section 513.. | ||||||
| 4 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf... | ||||||
| 5 | The value of services or facilities furnished by a governmental unit to the organization without charge.. | ||||||
| 6 | Total. Add lines 1 through 5. | 153,701 | 209,671 | 186,453 | 238,147 | 262,442 | 1,050,414 |
| 7a | Amounts included on lines 1, 2, and 3 received from disqualified persons... | 0 | |||||
| b | Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year. | 0 | |||||
| c | Add lines 7a and 7b.. | 0 | |||||
| 8 | Public Support (Subtract line 7c from line 6.) | 1,050,414 | |||||
| Calendar year (or fiscal year beginning in) | (a) 2006 | (b) 2007 | (c) 2008 | (d) 2009 | (e) 2010 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 153,701 | 209,671 | 186,453 | 238,147 | 262,442 | 1,050,414 |
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 1,958 | 1,939 | 2,039 | 520 | 6,456 | |
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | ||||||
| c | Add lines 10a and 10b. | 1,958 | 1,939 | 2,039 | 520 | 6,456 | |
| 11 | Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on. | 1,298 | 38,161 | 39,459 | |||
| 12 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.) | 4,684 | 1,193 | 3,235 | 4,310 | 2,520 | 15,942 |
| 13 | Total support (Add lines 9, 10c, 11 and 12.). | 158,385 | 214,120 | 229,788 | 244,496 | 265,482 | 1,112,271 |




| Facts And Circumstances Test |
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| Explanation |
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| SCHEDULE A, PART II, LINE 12, EXPLANATION OF OTHER INCOME: MISCELLANEOUS REVENUE |
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Attach to Form 990 or 990-EZ.| Identifier | Return Reference | Explanation |
|---|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | AN INDIVIDUAL IS CONSIDERED A MEMBER OF THE ORGANIZATION IF THEY ARE OLDER THAN 18 YEARS OF AGE AND: A. THEY HAVE A CHILD, OR ARE GUARDIAN OF A CHILD, WHO IS A PARTICIPANT IN THE PROGRAM; B. THEY ARE A NON-PARENT VOLUNTEER; C. THEY ARE A ROSTERED COACH; D. THEY ARE A MEMBER OF THE ORGANIZATION'S BOARD OF DIRECTORS; OR E. THEY HAVE BEEN A PAID EMPLOYEE OF THE ORGANIZATION FOR THE PAST TWO CALENDAR YEARS. | |
| FORM 990, PART VI, SECTION B, LINE 11 | THE FORM 990 WILL BE PRESENTED AT THE FIRST BOARD MEETING AFTER THE RETURN IS FILED; THE BOARD MEETS THE FIRST MONDAY OF EACH MONTH. | |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION'S GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. THE ORGANIZATION DOES NOT HAVE A CONFLICT OF INTEREST POLICY. |
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| Software Version: |