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
NORTHFIELD MOUNT HERMON SCHOOL
Employer identification number
04-2109865
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.") .
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......
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.
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.)
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...
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.).
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 E(Form 990 or 990-EZ) Department of the TreasuryInternal Revenue Service
SchoolsComplete if the organization answered "Yes" to Form 990, Part IV, line 13,or Form 990-EZ, Part VI, line 48. Attach to Form 990 or Form 990-EZ.
OMB No. 1545-0047
2011
Open to Public Inspection
Name of the organization
NORTHFIELD MOUNT HERMON SCHOOL
Employer identification number
04-2109865
Part I
YES
NO
1
Does the organization have a racially nondiscriminatory policy toward students by statement in its charter, bylaws,
other governing instrument, or in a resolution of its governing body?
......................
1
Yes
2
Does the organization include a statement of its racially nondiscriminatory policy toward students in all its
brochures, catalogues, and other written communications with the public dealing with student admissions,
programs, and scholarships?
......................................
2
Yes
3
Has the organization publicized its racially nondiscriminatory policy through newspaper or broadcast media during
the period of solicitation for students, or during the registration period if it has no solicitation program, in a way
that makes the policy known to all parts of the general community it serves? If "Yes," please describe. If "No,"
please explain. If you need more space use Part II.
.............................
3
Yes
4
Does the organization maintain the following?
a
Records indicating the racial composition of the student body, faculty, and administrative staff?
..........
4a
Yes
b
Records documenting that scholarships and other financial assistance are awarded on a racially nondiscriminatory
Other extracurricular activities?
.....................................
5h
No
If you answered "Yes" to any of the above, please explain. If you need more space, use Part II.
6a
Does the organization receive any financial aid or assistance from a governmental agency?
...........
6a
Yes
b
Has the organization's right to such aid ever been revoked or suspended?
...................
6b
No
If you answered "Yes" to either line 6a or line 6b, explain on Part II.
7
Does the organization certify that it has complied with the applicable requirements of sections 4.01 through 4.05
of Rev. Proc. 75-50, 1975-2 C.B. 587, covering racial nondiscrimination? If "No," explain on Part II.
7
Yes
Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50085D
Schedule E (Form 990 or 990-EZ) 2011
Schedule E (Form 990 or 990EZ) 2011
Page 2
Part II
Supplemental Information
Complete this part to provide the explanations required by Part I, lines 3, 4d, 5h, 6b, and 7, as applicable. Also complete this part to provide any other additional information (see instructions).
Identifier
Return Reference
Explanation
SCHEDULE E, PART I, LINE 3:
NOTICE OF NONDISCRIMINATION POLICY PUBLICIZED IN NEWSPAPERS AS A LISTED MEMBER OF THE ASSOCIATION OF INDEPENDENT SCHOOLS OF NEW ENGLAND (AISNE).
SCHEDULE E, PART I, LINE 6A:
UPWARD BOUND PROGRAM $335,788; FEDERAL GRANT NUMBER E-PO 47AS20398
Schedule E (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
NORTHFIELD MOUNT HERMON SCHOOL
Employer identification number
04-2109865
Identifier
Return Reference
Explanation
FORM 990, PART III, LINE 4A:
NORTHFIELD MOUNT HERMON SCHOOL (NMH) GIVES YOUNG PEOPLE AN EXCEPTIONAL ACADEMIC EXPERIENCE TAUGHT BY EXPERT, CARING FACULTY. NMH IS A SECULAR COED BOARDING AND DAY SCHOOL FOR 645 STUDENTS IN GRADES NINE THROUGH TWELVE AND POST GRADUATE. OUR BEAUTIFUL WOODED CAMPUS BORDERS THE CONNECTICUT RIVER IN WESTERN MASSACHUSETTS' PIONEER VALLEY. HERE, WE CHALLENGE STUDENTS TO THINK CRITICALLY AND TO CHANNEL THEIR TALENTS TO DO GOOD IN THE WORLD, INSPIRING IN THEM A SENSE OF PURPOSE. AT NMH, A CONSTELLATION OF ADULTS INTERACT WITH AND SUPPORT STUDENTS THROUGHOUT THE DAY. CLASSES ARE SMALL AND EXTENDED TO ALLOW STUDENTS TO EXPLORE EACH SUBJECT IN DEPTH. STUDENTS TAKE THREE MAJOR COURSES EACH SEMESTER FOR A TOTAL OF SIX CHALLENGING COLLEGE-PREPAraTORY COURSES PER YEAR. THE SCHOOL OFFERS AN EXTENSIVE CHOICE OF SPORTS TEAMS, PERFORMING ARTS GROUPS, CLUBS AND STUDY-ABROAD OPTIONS. MORE THAN 200 STUDENTS VOLUNTEER EACH SEMESTER IN OUTREACH ACTIVITIES. STUDENTS HELP RUN OUR WORKING FARM, WHICH HAS BEEN IN OPERATION SINCE THE SCHOOL'S FOUNDING IN 1879.
FORM 990, PART III, LINE 4B
NORTHFIELD MOUNT HERMON SCHOOL (nmh) SUMMER SESSION OFFERS PROGRAMS FOR STUDENTS WISHING TO ENRICH, SUPPLEMENT, OR ACCELERATE THEIR SCHOOL-YEAR EDUCATION. WE HAVE AN EXTENSIVE, COMPREHENSIVE PROGRAM THAT HAS EXISTED IN VARIOUS FORMS FOR MORE THAN 100 YEARS. EACH SUMMER, WE GATHER AS A COMMUNITY TO ENGAGE IN ACADEMIC WORK AND TO LEARN FROM EACH OTHER IN MANY DIFFERENT WAYS. OUR STUDENT POPULATION IS DIVERSE AND WORlDLY -- IN THE SUMMER OF 2012, 37 DIFFERENT COUNTRIES AND 22 STATES WITHIN THE US WERE REPRESENTED. OUR TALENTED FACULTY IS ASSISTED BY 30 TEACHING INTERNS TO PROVIDE AN OUTSTANDING EXPERIENCE FOR OUR STUDENTS. OUR GOAL, THROUGH ALL ASPECTS OF OUR COMPREHENSIVE PROGRAM, IS TO PROVIDE A VALUABLE, LIFE-CHANGING EXPERIENCE FOR EACH STUDENT WHO JOINS US. FOR MANY STUDENTS, NMH SUMMER SESSION PROVIDES THEIR FIRST TASTE OF A RIGOROUS ACADEMIC EXPERIENCE AND CHALLENGES THEM TO A NEW LEVEL. OTHER STUDENTS COME FROM STRONG SCHOOLS AND USE THEIR SUMMER HERE AS AN OPPORTUNITY TO FURTHER BUILD ACADEMIC SKILLS, ADVANCE IN THEIR COURSEWORK AND PREPARE FOR COLLEGE.
FORM 990, PART VI - SECTION A, LINE 2:
ELLEN W. PAYZANT AND THOMAS W. PAYZANT HAVE A FAMILY RELATIONSHIP.
FORM 990, PART VI - SECTION A, LINE 11B:
ONCE NORTHFIELD MOUNT HERMON SCHOOL (NMH)'S FORM 990 IS COMPLETED, IT IS FIRST REVIEWED BY NMH'S INTERNAL MANAGEMENT. FOLLOWING THAT REVIEW, NMH'S INTERNAL MANAGEMENT AND OUTSIDE ADVISORS PRESENT THE FORM 990 (EXCLUDING SCHEDULE B) TO THE AUDIT COMMITTEE FOR REVIEW AND COMMENT. THE HEAD OF SCHOOL REVIEWS SCHEDULE B WITH THE CHAIR OF THE BOARD OF TRUSTEES. THE COMPLETED FORM 990 (EXCLUDING SCHEDULE B) IS PROVIDED TO ALL BOARD MEMBERS PRIOR TO THE FORM BEING FILED WITH THE IRS.
FORM 990, PART VI - SECTION B, LINE 12C:
NORTHFIELD MOUNT HERMON SCHOOL (NMH) MAINTAINS A WRITTEN CONFLICT OF INTEREST POLICY REQUIRING DISCLOSURE OF RELEVANT FACTS THAT GIVE RISE TO A POTENTIAL CONFLICT OF INTEREST. ANNUALLY, OFFICERS, KEY EMPLOYEES AND BOARD MEMBERS ARE REQUIRED TO ACKNOWLEDGE IN WRITING THAT THEY HAVE READ AND UNDERSTOOD THE CONFLICT OF INTEREST POLICY. ADDITIONALLY, EACH OFFICER, KEY EMPLOYEE, AND BOARD MEMBER ACKNOWLEDGES WITH SIGNATURE THAT NO CONFLICT OF INTEREST EXISTS, OR PROVIDES DISCLOSURE OF A CONFLICT. THE FORMS ARE RETURNED TO THE CFO AND TREASURER. IF A CONFLICT EXISTS, THAT MEMBER MAY NOT BE PRESENT FOR DELIBERATIONS OR PARTICIPATE IN DECISIONS FOR A TRANSACTION INVOLVING A CONFLICT OF INTEREST.
FORM 990, PART VI - SECTION B, LINE 14:
NORTHFIELD MOUNT HERMON SCHOOL (NMH) CURRENTLY HAS PRACTICES AND PROCEDURES AROUND DOCUMENT RETENTION AND DESTRUCTION. NMH IS IN THE PROCESS OF FORMALIZING THESE PRACTICES INTO A WRITTEN POLICY.
FORM 990, PART VI - SECTION B, LINE 15 A & B:
NORTHFIELD MOUNT HERMON SCHOOL (NMH) HAS AN INDEPENDENT COMPENSATION AND BENEFITS COMMITTEE THAT REVIEWS ANNUALLY THE PERFORMANCE OF THE HEAD AND THE SENIOR STAFF BASED ON FEEDBACK SHARED FROM ALL INDEPENDENT TRUSTEES. DURING ITS REVIEW OF THAT FEEDBACK AND CONSIDERING AVAILABLE ANALYTICAL MARKET DATA, THE COMMITTEE SETS THE COMPENSATION OF THE HEAD OF SCHOOL FOR THE UPCOMING YEAR. AT THE FALL MEETING OF THE FULL BOARD, THE COMMITTEE GIVES AN ORAL REPORT OF ITS FINDINGS AND RECOMMENDATIONS TO THE EXECUTIVE COMMITTEE. THE HEAD IS RESPONSIBLE FOR SETTING THE COMPENSATION FOR THE SENIOR STAFF BASED ON COMPARABLE MARKET DATA.
FORM 990, PART VI - SECTION C, LINE 19:
NORTHFIELD MOUNT HERMON SCHOOL'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST.
FORM 990, PART XI, LINE 5:
OTHER CHANGES IN NET ASSETS: UNREALIZED GAIN ON ASSET RETIREMENT OBLIGATION $26,495 UNREALIZED LOSSES ON INVESTMENTS: ($2,262,850) CHANGE IN FAIR FALUE OF SWAP AGREEMENTS: ($9,432,062) REALIZED LOSS ON SWAP AGREEMENTS: ($1,983,948) ------------- TOTAL OTHER CHANGES IN NET ASSETS ($13,652,365)
SCHEDULE K, PART IV, LINES 3B & 3C:
NAME OF PROVIDERS: BANK OF NY MORGAN STANLEY MORGAN STANLEY TERM OF HEDGE: 14.25% 24.25% 32.25%
For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.