VSA Arts of Georgia

Georgia Community Support & Solutions

Community Events Agency Update

July 2019 - June 2020


Please complete both the PDF Agency Invoice Form and the electronic Agency Update Form. Mail or email completed PDF Agency Invoice Form to:

Mail: VSA arts of Georgia, Georgia Community Support & Solutions, 1945 Cliff Valley Way, Suite 220, Atlanta, GA 30329

Email: Joan.Puckett@VSAartsGA.org

AGENCY INVOICE FORM 2020-2021 PDF


Mailing Address *
Mailing Address
http://
Staff Contact at Agency *
Staff Contact at Agency
Person who will handle ticket requests.
Phone *
Phone
All information must be completed and returned for continued service. Please fill out completely - our funders require this information.
Areas of Service *
Check all that apply
Other Area of Service not listed above.
Indicate % of funding from each source:
If yes, please contact the Program Coordinator BEFORE completing this form.
All updates are sent via E-MAIL. Please ensure that we have a current address and that your system is set up to receive messages from us, including adding us to your address book or whitelist. NOTE: Be prepared to provide a current (date stamped) 501c (3) letter before we process your payment. The name on the 501c (3) status letter must be the name of your program/agency (i.e., cannot be the name of a church). ALL renewals will be vetted through the IRS for a current Form 990. (If you have not filed a current IRS Form 990, your renewal will not be processed.
Briefly state the general purpose and goals of your agency – what you do, not your mission statement.
Demographic Info – Our donors require this information from us.
Information Source: Agency Data Of the total number of people served each year, what percent are:
(maximum $24,250/year for a family of 4)
(maximum $29,100/year for a family of 4)
Agency Certification
We certify that the information included in this agency update is true and complete to the best of our knowledge.
Agency Director *
Agency Director
Agency Director *
Date *
Date
Phone *
Phone
Staff Contact at Agency *
Staff Contact at Agency
Staff Contact *
Date *
Date
Phone *
Phone