Culturally Significant Non-Profit Recommendation Form

SECTION 1: Basic Information

1. Name of Non-Profit Organization

Non Profit Organization Image

2. Location (City, State)

(City, State)

If a secondary city is influenced, please enter it here.

(City, State)

3. Website or Social Media (optional)

4. Primary Contact Person (optional)

5. Type of Organization (e.g., 501(C)(3), grassroots, mutual aid, etc.)

SECTION 2: Cultural Focus Area

6. What is the organization’s primary cultural impact area?

Health, Wellness, and Education (Initiatives focused on health, holistic wellness and education)
Economic Opportunity and Equality (Non-profits that empower, assemble and/or align with cultural integrity and community values)
Arts, Community, and Heritage (Creative expressions and heritage initiatives that define cultural identity)

SECTION 3: Cultural Relevance & Identity

7. Briefly describe the mission and/or main activities that contribute to being culturally significant.

Note: This answer will be published to the public dashboard library and viewable by everyone as an explanation of why considered culturally significant. If you need guidance, please refer to the Cultural Significance Checklist.

8. Is the non-profit led by or rooted in a specific cultural, ethnic, or social group?

Yes
No
Not sure

9. How does the organization represent and serve that community?

10: Does the non-profit serve multiple cultural or ethnic groups?

Yes
No
Not sure

11: Please describe its engagement across diverse communities.

SECTION 4: Charitable Work and Partnerships

12. What programs, events, or services does the organization provide that promote cultural preservation, social equity, or community empowerment?

13. List any collaborations with cultural institutions, grassroots groups, or international partners.

14. Does the organization measure the outcomes of its programs (e.g., community impact, participation, growth)?

Yes
No
Not sure

15. Please describe how impact is tracked or evaluated.

SECTION 5: Financial Contributions and Giving

16. Does the organization make charitable contributions or provide funding to others (e.g., microgrants, scholarships, program sponsorships)?

Yes
No
Not sure

17. Approximately how much does the organization give annually (in dollars)?

(Example: $5,000, $15,000–$30,000, etc.)

18. What percentage of the annual budget (if known) is allocated to community giving?

19. List examples of supported initiatives or recipients (if applicable).

SECTION 6: Cultural Authenticity & Representation

20. Are the programs or initiatives based in authentic cultural practices?

Yes
No
Not sure

21. How does the organization ensure it avoids cultural appropriation or misrepresentation?

SECTION 7: Culturally Significant Events

22. Does the organization host or sponsor any local events that are culturally significant?

Yes
No
Not sure

23. Name of the event (if applicable):

24. Please describe the event, its cultural importance, who it serves, and how often it is held.

Example: Annual Indigenous Heritage Festival celebrating local traditions, language, and crafts.

25. How does the event engage the community and reflect cultural values or identity?

SECTION 8: Additional comments (Optional)

26. Is there anything else you’d like to share about this non-profit’s cultural impact?

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Culturally Significant Non-Profit Recommendation Form

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