S
E
E
O
A
URVEY ON
NSURING
QUAL
PPORTUNITY FOR
PPLICANTS
. 2/28/2009
OMB N
. 1890-0014 E
O
XP
Purpose: The Federal government is committed to ensuring that all qualified applicants, small or large, non-religious or faith-
based, have an equal opportunity to compete for Federal funding. In order for us to better understand the population of applicants
for Federal funds, we are asking nonprofit private organizations (not including private universities) to fill out this survey.
Upon receipt, the survey will be separated from the application. Information provided on the survey will not be considered in any
way in making funding decisions and will not be included in the Federal grants database. While your help in this data collection
process is greatly appreciated, completion of this survey is voluntary.
Instructions for Submitting the Survey: If you are applying using a hard copy application, please place the completed survey in an
envelope labeled “Applicant Survey.” Seal the envelope and include it along with your application package. If you are applying
electronically, please submit this survey along with your application.
Applicant’s (Organization) Name: ______________________________________________________________
Applicant’s DUNS Number: ___________________________________________________________________
Grant Name: ____________________________________________________CFDA Number: _____________
4. Is the applicant a faith-based/religious
1. Does the applicant have 501(c)(3) status?
organization?
Yes
No
Yes
No
2. How many full-time equivalent employees does
5. Is the applicant a non-religious community-based
the applicant have? (Check only one box).
organization?
3 or Fewer
15-50
Yes
No
4-5
51-100
6-14
over 100
6. Is the applicant an intermediary that will manage
the grant on behalf of other organizations?
Yes
No
3. What is the size of the applicant’s annual budget?
(Check only one box.)
7. Has the applicant ever received a government
Less Than $150,000
grant or contract (Federal, State, or local )?
$150,000 - $299,999
Yes
No
$300,000 - $499,999
8. Is the applicant a local affiliate of a national
$500,000 - $999,999
organization?
$1,000,000 - $4,999,999
Yes
No
$5,000,000 or more
SF 424 Supplement