Securing Assets for Grassroots Empowerment (SAGE) Inquiry Intake Sheet

Date:

Organization:

Address:

Telephone: Fax:

Email:

Executive Director:

Contact Person (if different from above) :

How did you hear about SAGE?

Board President/Chair:

Number of Board Members:

Director of Development:

Number of Staff:

Number of Volunteers:

Annual Budget:

Mission:

Comments: (for office use)