Department of the Treasury Internal Revenue Service
Public Charity Status and Public Support
Complete if the organization is a section 501(c)(3) organization or a section
4947(a)(1) nonexempt charitable trust.
Attach to Form 990 or Form 990-EZ. See separate instructions.
OMB No. 1545-0047
2011
Open to Public Inspection
Name of the organization
FLOURISH FOUNDATION INC
Employer identification number
27-4446378
Part I
Reason for Public Charity Status
(All organizations must complete this part.) See instructions
The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)
1
2
3
4
5
section 170(b)(1)(A)(iv). (Complete Part II.)
6
7
8
9
receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of
its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses
acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)
10
11
e
By checking this box, I certify that the organization is not controlled directly or indirectly by one or more disqualified persons other than foundation managers and other than one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2).
f
If the organization received a written determination from the IRS that it is a Type I, Type II or Type III supporting organization, check this box
..................................................
g
Since August 17, 2006, has the organization accepted any gift or contribution from any of the following persons?
(i) a person who directly or indirectly controls, either alone or together with persons described in (ii)
Yes
No
and (iii) below, the governing body of the the supported organization?
................
11g(i)
(ii)
a family member of a person described in (i) above?
......................
11g(ii)
(iii)
a 35% controlled entity of a person described in (i) or (ii) above?
................
11g(iii)
h
Provide the following information about the supported organization(s).
(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?
Yes
No
Yes
No
Yes
No
Total
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 11285F
Schedule A (Form 990 or 990-EZ) 2011
Schedule A (Form 990 or 990-EZ) 2011
Page 2
Part II
Support Schedule for Organizations Described in IRC 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi) (Complete only if you checked the box on line 5, 7, or 8 of Part I or if the
organization failed to qualify under Part III. If the organization fails to
qualify under the tests listed below, please complete Part III.)
Section A. Public Support
Calendar year(or fiscal year beginning in)
(a) 2007
(b) 2008
(c) 2009
(d) 2010
(e) 2011
(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.
Section B. Total Support
Calendar year(or fiscal year beginning in)
(a) 2007
(b) 2008
(c) 2009
(d) 2010
(e) 2011
(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).
12
Gross receipts from related activities, etc. (See instructions.)
..................
12
13
First Five Years
If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization,
check this box and stop here..........................................
Section C. Computation of Public Support Percentage
14
Public Support Percentage for 2010 (line 6 column (f) divided by line 11 column (f))
.........
14
15
Public Support Percentage for 2009 Schedule A, Part II, line 14
...............
15
16a
33 1/3% support test—2011.
If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization
......................
b
33 1/3% support test—2010.
If the organization did not check the box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization
.....................
17a
10%-facts-and-circumstances test—2011.
If the organization did not check a box on line 13, 16a, or 16b and line 14
is 10% or more, and if the organization meets the "facts and circumstances" test, check this box and stop here. Explain
in Part IV how the organization meets the "facts and circumstances" test. The organization qualifies as a publicly supported
organization
..................................................
b
10%-facts-and-circumstances test—2010.
If the organization did not check a box on line 13, 16a, 16b, or 17a and line
15 is 10% or more, and if the organization meets the "facts and circumstances" test, check this box and stop here.
Explain in Part IV how the organization meets the "facts and circumstances" test. The organization qualifies as a publicly supported organization
..............................................
18
Private Foundation
If the organization did not check a box on line 13, 16a, 16b, 17a or 17b, check this box and see
instructions
...................................................
Schedule A (Form 990 or 990-EZ) 2011
Schedule A (Form 990 or 990-EZ) 2011
Page 3
Part III
Support Schedule for Organizations Described in IRC 509(a)(2) (Complete only if you checked the box on line 9 of Part I or if the organization
failed to qualify under Part II. If the organization fails to qualify under
the tests listed below, please complete Part II.)
Section A. Public Support
Calendar year(or fiscal year beginning in)
(a) 2007
(b) 2008
(c) 2009
(d) 2010
(e) 2011
(f) Total
1
Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .
30
35,676
35,706
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......
4,800
4,800
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.
30
40,476
40,506
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.)
40,506
Section B. Total Support
Calendar year (or fiscal year beginning in)
(a) 2007
(b) 2008
(c) 2009
(d) 2010
(e) 2011
(f) Total
9
Amounts from line 6...
30
40,476
40,506
10a
Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..
b
Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.
c
Add lines 10a and 10b.
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.).
30
40,476
40,506
14
First Five Years
If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a 501(c)(3) organization,
check this box and stop here.............................................
Section C. Computation of Public Support Percentage
15
Public Support Percentage for 2011 (line 8 column (f) divided by line 13 column (f))
.........
15
16
Public support percentage from 2010 Schedule A, Part III, line 15
...............
16
Section D. Computation of Investment Income Percentage
17
Investment income percentage for 2011 (line 10c column (f) divided by line 13 column (f))
......
17
18
Investment income percentage from 2010 Schedule A, Part III, line 17
.............
18
19a
33 1/3% support tests—2011.
If the organization did not check the box on line 14, and line 15 is more than 33 1/3% and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization
..........
b
33 1/3% support tests—2010.
If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization
....
20
Private Foundation
If the organization did not check a box on line 14, 19a or 19b, check this box and see instructions
.....
Schedule A (Form 990 or 990-EZ) 2011
Schedule A (Form 990 or 990-EZ) 2011
Page 4
Part IV
Supplemental Information.
Supplemental Information. Complete this part to provide the explanation required by Part II, line 10; Part II, line 17a or 17b; or Part III, line 12. Also complete this part for any additional information. (See instructions).
Facts And Circumstances Test
Explanation
Schedule A (Form 990 or 990-EZ) 2011
Additional Data
Software ID:
Software Version:
-
TIN:
SCHEDULE O (Form 990 or 990-EZ)
Department of the Treasury Internal Revenue Service
Supplemental Information to Form 990 or 990-EZ
Complete to provide information for responses to specific questions on
Form 990 or to provide any additional information.
Attach to Form 990 or 990-EZ.
OMB No. 1545-0047
2011
Open to Public Inspection
Name of the organization
FLOURISH FOUNDATION INC
Employer identification number
27-4446378
Identifier
Return Reference
Explanation
ORGANIZATION'S MISSION
FORM 990 - ORGANIZATION'S MISSION
THE FLOURISH FOUNDATION IS DEDICATED TO PROMOTING CONTEMPLATIVE-BASED PRACTICES IN COMMUNITIES FOR THE PURPOSE OF ACHIEVING MENTAL BALANCE AND COMPASSION. THE HEART OF OUR WORK FOCUSES ON THE HUMAN POTENTIAL TO BE MORALLY AND ETHICALLY RESPONSIBLE WORLD CITIZENS.
EXPLANATION ON VOLUNTEERS AND TYPES OF SERVICES OR BENEFITS
FORM 990, PAGE 1, PART I, LINE 6
OFFICERS ARE VOLUNTEERS.
ANY SIGNIFICANT NEW PROGRAM SERVICES NOT LISTED ON A PRIOR RETURN
FORM 990, PAGE 2, PART III, LINE 2
ALL PROGRAMS BEGAN IN 2011 AND WERE NOT INCLUDED IN THE PROGRAMS FOR 2010.
SECOND ACCOMPLISHMENT DESCRIPTION
FORM 990, PAGE 2, PART III, LINE 4B
FOLLOW-THROUGH OF THEIR PROJECTS IN PREPARATION FOR THEIR TRIP IN 2012.
THIRD ACCOMPLISHMENT DESCRIPTION
FORM 990, PAGE 2, PART III, LINE 4C
FLOURISH FOUNDATION OFFERS SCHOOL-BASED PROGRAMS THAT INTRODUCE DIFFERENT FORMS OF MINDFUL AWARENESS TRAINING TO STUDENTS AND TEACHERS IN A CLASSROOM SETTING. THE GOAL OF THE MINDFUL AWARENESS PROGRAM (MAP) IS CENTERED ON BROADENING THE SCOPE OF EDUCATION TO INCLUDE SOCIAL AND EMOTIONAL SKILLS, ATTENTIONAL TRAINING, AND THE DEVELOPMENT OF OTHER VIRTUES THAT SUPPORT PERSONAL, SOCIAL, AND ENVIRONMENTAL HEALTH AND WELL BEING. THE MAP PROGRAM USES SECULAR, AGE APPROPRIATE EXERCISES AND GAMES TO CULTIVATE ATTENTION, AWARENESS, ENVIRONMENTAL SENSITIVITY, AND TO DEVELOP THE POSITIVE EMOTIONS OF KINDNESS AND COMPASSION. IN 2011 WE TAUGHT EIGHT CLASSES IN LOCAL GRADE SCHOOLS TO APPROXIMATELY 135 FIFTH GRADE STUDENTS.
ALL OTHER ACCOMPLISHMENT DESCRIPTION
FORM 990, PAGE 2, PART III, LINE 4D
TWO OTHER PROGRAMS EXIST: THE BIRTH PROGRAM AND THE TEACHER SELF-CARE PROGRAM. MINDFUL CHILDBIRTH & PARENTING CLASSES THROUGH THE PRACTICE OF MINDFULNESS, EXPECTANT PARENTS WILL DEVELOP TOOLS FOR MANAGING EMOTIONAL AND PHYSICAL STRESS DURING PREGNANCY, CHILDBIRTH, PARENTING, AND DAILY LIFE. PARTICIPANTS WILL LEARN HOW TO ENGAGE THE MIND TO DEAL WITH PAIN AND FEAR ASSOCIATED WITH CHILDBIRTH AND HOW TO ACCESS DEEP PHYSICAL AND MENTAL RELAXATION TO GREATLY ASSIST THE NATURAL PROCESS OF CHILDBIRTH AND EASE THE WAY INTO PARENTHOOD. BY PRACTICING MINDFUL AWARENESS, EXPECTING PARENTS ARE ABLE TO ADJUST THROUGH THIS TRANSITION WITH GREATER CONFIDENCE, WISDOM AND JOY. TEACHER SELF-CARE PROGRAM AS EDUCATORS, SCHOOL TEACHERS REPRESENT A CORNERSTONE OF OUR SOCIETY. ACCORDING TO THE UNITED STATES DEPARTMENT OF EDUCATION, OF ALL THE WORK THAT OCCURS AT EVERY LEVEL OF OUR EDUCATION SYSTEM, THE INTERACTION BETWEEN TEACHER AND STUDENT IS THE PRIMARY DETERMINANT OF STUDENT SUCCESS. THE IMPORTANCE OF THIS IS ASTONISHING, YET MOST TEACHERS ARE NOT GIVEN THE TOOLS TO ADDRESS THE HIGH LEVELS OF STRESS AND BURNOUT, WHICH ARE SO EVIDENT IN THE PROFESSION. STUDIES HAVE SHOWN THAT INTRODUCING CONTEMPLATIVE PRACTICES INTO THE LIVES OF TEACHERS REDUCES THEIR PERCEIVED STRESS, ANXIETY AND BURNOUT, WHILE LEADING TO INCREASED EMPATHY AND COMPASSION. IDEALLY, SUPPORTING TEACHERS IN THIS WAY CREATES STUDENT- TEACHER RELATIONSHIPS AND CLASSROOM ENVIRONMENTS THAT FOSTER THE DEVELOPING MINDS/BRAINS OF CHILDREN SPECIFICALLY IN TERMS OF SELF-CONTROL, STRESS REDUCTION, AND POSITIVE FEELINGS TOWARD THEM AND THE WORLD. THE FLOURISH FOUNDATION OFFERS AN ELEVEN WEEK TEACHER SELF-CARE PROGRAM THAT SUPPORTS TEACHERS IN DEVELOPING THEIR OWN INNER RESOURCES THROUGH CONTEMPLATIVE PRACTICES, REFLECTION AND DIALOGUE.
DOCUMENTATION BY GOVERNING BODY
FORM 990, PAGE 6, PART VI, LINE 8A
MINUTES TAKEN AT ALL MEETINGS.
ORGANIZATION'S PROCESS USED TO REVIEW FORM 990
FORM 990, PAGE 6, PART VI, LINE 11B
ORGANIZATIONAL QUESTIONS ANSWERED BY 2011 VICE PRESIDENT AND SECRETARY. DRAFT 990 TRANSMITTED TO BOARD MEMBERS ELECTRONICALLY. THEY REVIEW AND THEN PROVIDE INPUT PRIOR TO FINAL DRAFT.
ENFORCEMENT OF CONFLICTS POLICY
FORM 990, PAGE 6, PART VI, LINE 12C
BOARD AND STAFF RECEIVE CONFLICT OF INTEREST POLICY ANNUALLY, REVIEW AND SIGN. DISCLOSURE AND REVIEW AT BOARD MEETING. AS THERE ARE ONLY THREE BOARD MEMBERS, CONFLICT OF INTEREST IS EASILY DISCERNABLE IF IT IS PRESENT.
GOVERNING DOCUMENTS DISCLOSURE EXPLANATION
FORM 990, PAGE 6, PART VI, LINE 19
ALL DOCUMENTS ARE AVAILABLE UPON REQUEST FOR 2010. 2011 WILL APPEAR ON CHARITY WEB PAGES THAT POST 990'S AS WELL AS UPON DEMAND. DISCUSSION CONTINUES ABOUT POSTING ON FLOURISH WEBSITE AT HTTP://FLOURISHFOUNDATION.ORG
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.