Nonprofit Support Intake Form

This form should take approximately 5–10 minutes to complete. Thank you for helping us understand your organization’s needs!

Step 1 of 5

20%

Organization Information

Organization Name(Required)

Website URL

Primary Contact Name(Required)

Primary Contact Email(Required)

Primary Contact Phone Number

Location(Required)

City State / Province / Region Country

About Your Organization

Mission Statement

Which best describes your organization’s primary focus?(Required)

Affordable Housing

Food Security

Social Justice

Education

Healthcare

Environmental Justice

Other

Does your organization primarily serve majority BIPOC communities?

Yes

Is your organization BIPOC-led?

Yes

Funding Information

What is your organization’s primary source of funding? (Select all that apply):

Individual donations

Government grants

Foundation grants

Corporate sponsorships

Earned income (e.g., fees for services or products)

Other

Do you currently receive funding or grants from foundations?

Yes

If yes, which foundations currently support your organization?

What is your organization’s annual budget?

Less than $50,000

$50,000–$200,000

$200,000–$500,000

More than $500,000

Service Needs

What type of support are you seeking? (Select all that apply):

Cybersecurity assessment

IT support/consultation

Staff training on cybersecurity practices

Recommendations for software/tools

Other

Please describe your organization's current cybersecurity/IT challenges:

Do you currently have an IT or cybersecurity team/staff?

Yes

How many staff or volunteers would require IT/cybersecurity support?

Other Information

How did you hear about Mission Secure?

Referral

Social Media

Web Search

Event/Conference

Other

Is there any additional information you’d like us to know about your organization or your needs?

Consent and Submission

Consent to Contact:(Required)

By submitting this form, you agree to allow Mission Secure to contact you regarding your inquiry and provide further assistance.

X/Twitter

This field is for validation purposes and should be left unchanged.

Name(Required)

First Last

Email(Required)

Contact

chris@missionsecure.org

Social Links

Instagram
LinkedIn

Together, we can build a more secure and equitable future for the organizations driving positive community change.