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 | 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...... | 86,717 | 98,479 | 160,080 | 216,976 | 257,736 | 819,988 |
| 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. | 86,717 | 98,479 | 160,080 | 216,976 | 257,736 | 819,988 |
| 7a | Amounts included on lines 1, 2, and 3 received from disqualified persons... | ||||||
| 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. | ||||||
| c | Add lines 7a and 7b.. | ||||||
| 8 | Public Support (Subtract line 7c from line 6.) | 819,988 | |||||
| Calendar year (or fiscal year beginning in) | (a) 2006 | (b) 2007 | (c) 2008 | (d) 2009 | (e) 2010 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 86,717 | 98,479 | 160,080 | 216,976 | 257,736 | 819,988 |
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 82 | 556 | 638 | |||
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | ||||||
| c | Add lines 10a and 10b. | 82 | 556 | 638 | |||
| 11 | Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on. | ||||||
| 12 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.) | ||||||
| 13 | Total support (Add lines 9, 10c, 11 and 12.). | 86,717 | 98,479 | 160,080 | 217,058 | 258,292 | 820,626 |




| Facts And Circumstances Test |
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| Explanation |
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Attach to Form 990 or 990-EZ.| Identifier | Return Reference | Explanation |
|---|---|---|
| 01. Form 990 governing body review (Part VI, line 11) | A copy of the Form 990 was provided to the organizations governing body before it was filed The directors and key employees are an integral part of the form preparation and have reviewed the financial information that is contained in the form In addition board members have been consulted regarding questions that were addressed in the form The directors correspond on a regular basis with the Finance Coordinator and the independent accountant | |
| 02. Conflict of interest policy compliance (Part VI, line 12c) | Persons deemed to have any conflict of interest are restricted from the discussion and prohibited from voting on those matters This is monitored on a regular basis among the board members and other influential persons Persons serving on the Board of Directors do so on a voluntary basis They do not receive compensation for their service as such The two board members that are compensated for services to the organization are non-voting members on the board | |
| 03. CEO, executive director, top management comp (Part VI, line 15a) | When determining compensation of the executive director similar organizations have been surveyed The board strives to stay in line with the pay levels of other similar organizations The board is involved in the review and approval of salary increases Persons serving on the Board are not compensated and are prohibited from discussing or voting on the salary arrangements of any related party The Executive Director is a non-voting member of the board and is restricted from discussions regarding her pay | |
| 04. Other officer or key employee compensation (Part VI, line 15b | When determining compensation of key employees similar organizations have been surveyed The board strives to stay in line with the pay levels of other similar organizations The board is involved in the review and approval of salary increases Persons serving on the Board are not compensated and are prohibited from discussing or voting on the salary arrangements of any related party | |
| 05. Governing documents, etc, available to public (Part VI, line 19) | Form 1023 and Form 990 are made available to the public upon request The Finance Coordinator is responsible for providing the forms available for public inspection Policies regarding the operation of the program are posted on the website |
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