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? |
|||
|---|---|---|---|---|---|---|---|---|---|
| Yes | No | Yes | No | Yes | No | ||||
| Total | |||||||||
| 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. | 0 | |||||
| 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). | ||||||






| 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.") . | 10,300 | 62,425 | 84,019 | 100,000 | 256,744 | |
| 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...... | 6,070 | 18,170 | 6,193 | 3,080 | 33,513 | |
| 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. | 16,370 | 80,595 | 90,212 | 103,080 | 290,257 | |
| 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.) | 290,257 | |||||
| Calendar year (or fiscal year beginning in) | (a) 2007 | (b) 2008 | (c) 2009 | (d) 2010 | (e) 2011 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 16,370 | 80,595 | 90,212 | 103,080 | 290,257 | |
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 0 | |||||
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | 0 | |||||
| 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. | 0 | |||||
| 12 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part IV.) | 0 | |||||
| 13 | Total support (Add lines 9, 10c, 11 and 12.). | 16,370 | 80,595 | 90,212 | 103,080 | 290,257 | |




| Facts And Circumstances Test |
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| Explanation |
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| Software ID: | 11000218 |
| Software Version: | 2011.0.0 |
Attach to Form 990 or 990-EZ.| Identifier | Return Reference | Explanation |
|---|---|---|
| Form 990-EZ, Part I, Line 8, Other Revenue Gym rental 1,260 Form 990-EZ, Part I, Line 8, Other Revenue Varsity Rebate 1,820 Form 990-EZ, Part I, Line 16, Other Expenses Travel 2,227 Form 990-EZ, Part I, Line 16, Other Expenses Meals and entertainment 405 Form 990-EZ, Part I, Line 16, Other Expenses Fundraising 2,819 Form 990-EZ, Part I, Line 16, Other Expenses Conferences, conventions, and meetings 1,634 Form 990-EZ, Part I, Line 16, Other Expenses Depreciation 4,354 Form 990-EZ, Part I, Line 16, Other Expenses Equipment rental and maintenance 1,010 Form 990-EZ, Part I, Line 16, Other Expenses Supplies 34 Form 990-EZ, Part I, Line 16, Other Expenses Telephone 1,032 Form 990-EZ, Part I, Line 16, Other Expenses Bank Fees 287 Form 990-EZ, Part I, Line 16, Other Expenses Competition Fees 20,910 Form 990-EZ, Part I, Line 16, Other Expenses Insurance 775 Form 990-EZ, Part I, Line 16, Other Expenses Paypal Fees 835 Form 990-EZ, Part I, Line 16, Other Expenses Trophies 254 Form 990-EZ, Part I, Line 16, Other Expenses Water 1,029 Form 990-EZ, Part I, Line 16, Other Expenses Office Expenses 150 Form 990-EZ, Part I, Line 16, Other Expenses Program Expense 498 Form 990-EZ, Part I, Line 16, Other Expenses Utilities 2,782 Form 990-EZ, Part I, Line 16, Other Expenses First Aid Kits 683 Form 990-EZ, Part I, Line 16, Other Expenses Membership Fees 450 Form 990-EZ, Part I, Line 16, Other Expenses AA County Fees 389 Form 990-EZ, Part II, Line 24, Other Assets Inventory, Gym Equipment, Furniture,Floor Mats, Software Beginning of year 15,044, End of year 11,360 Form 990-EZ, Part II, Line 24, Other Assets Commerical Heater Beginning of year 781, End of year 590 Form 990-EZ, Part II, Line 24, Other Assets Lockers60 Beginning of year 750, End of year 566 Form 990-EZ, Part II, Line 24, Other Assets Crash Mat Fans Beginning of year 0, End of year 1,766 Form 990-EZ, Part II, Line 26, Liabilities Credit Card Balance Beginning of year 10,890, End of year 10,249 |
| Software ID: | 11000218 |
| Software Version: | 2011.0.0 |
| Person Name | Explanation |
|---|---|
| Barbara McKnew | Travel Allowance |
| Lori Hotzberger | Travel Allowance |