Smart Coin® Case Study Application

Nonprofit Beta Partner Application

Please complete this short form to apply as a beta partner. Selected nonprofits will be contacted with next steps.

Nonprofit Name

Website

http://

Point of Contact Name

First Name

Last Name

Phone

(###)

###

####

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

EIN / Tax ID

Mission Statement

Annual Operating Budget

Donor Database?

Approximate Number of Donors

Can you identify your top 1–5% donors?

Staff/Volunteer Capacity to Coordinate Pilot

Why would your nonprofit be a strong beta partner?

Open to Published Case Study?