KYC2020 Email Marketing -

Non-Profit Qualification Form

Email*

Phone*

Website*

What is the mission of your organization? Please provide a brief description.*

What services do you provide to the community?*

Do you serve in any sanctioned locations?*

Yes

No

If yes, list locations.

What is the size of your organization (in terms of staff and volunteers)?*

What is your annual budget?*

Please provide the name and contact information for the executive director or equivalent:

Name*

Title*

Email Address*

If yes, please indicate which services you are interested in:*

OFAC Screening Only

Sanction & PEP Screening

Adverse Media Screening

Case Management

Ongoing Monitoring

Help with AML Policy or Risk Assessment

If other, please specify

By entering my initials below, I certify that the information provided on this form is true and accurate to the best of my knowledge.

Initials*

Date*