Block 0 2015 Small Business Leadership Award for Mission Driven Lenders Nominee Questionnaire About the Small Business Leader Award The Small Business Leader Award for Mission Driven Lenders honors innovation and growth in missiondriven small business lenders. Now in its second year, this national award celebrates excellence, builds broad based awareness, and creates momentum for the small business lending sector. The 2015 Small Business Leader Award will recognize accelerated growth in small business lending, measured over three years. The awardee will receive a cash award of $50,000, recognition at the OFN Annual Conference in Detroit, November 2015, and other marketing and PR opportunities. The award is part of the Goldman Sachs 10,000 Small Businesses Financing Initiative, with additional support from the Goldman Sachs Foundation and the Surdna Foundation. For more information, visit: ofn.org/sb award or contact 10ksb@ofn.org. Nomination Process Nominations for the Small Business Leader Award require two submissions: Nominee questionnaire, with supporting documents, completed by nominated small business lender to be submitted through this online application. Nomination letter from an opportunity finance industry leader from outside your organization (she/he cannot be a staff member), to be sent by nominator to 10ksb@ofn.org. Time Line June 30, 2015 Nominations open. July 27, 2015 Nominations deadline. All nominations must include nomination letter and completed nominee questionnaire. November 9 11, 2015 Award announced at OFN Conference in Detroit. Only applications with both the nomination letter and the completed nominee questionnaire will be considered for the award. Selection Criteria and Eligibility Nominees for the 2015 Small Business Leader Award will be evaluated based upon their demonstrated https://eu.qualtrics.com/controlpanel/ajax.php?action=getsurveyprintpreview&t=6vd4thepbmpievjf7zzzqo 1/7
ability to significantly grow their small business lending, primarily in low income and low wealth communities. Nominees should demonstrate success and outcomes in the following areas: Accelerated growth in small business lending, measured over three years Excellence in mission, impact, and financial sustainability Nominations are open to CDFIs and other mission driven small business lenders that operate in the United States and carry on balance sheet lending. Nominees must also include loans of $50,000 or more in their small business lending portfolio. Small and emerging organizations and those led by people of color, as well as loan funds, credit unions, banks, and SBA Community Advantage lenders, are encouraged to apply. Note: Nominees do not have to be OFN Members, certified CDFIs, or existing Goldman Sachs 10,000 Businesses or Surdna Foundation partners to be eligible for the Small Business Leader Award. QUESTIONNAIRE This online nominee questionnaire is organized into four parts, which are: 1. Organizational Profile 2. Financial Performance and Sustainability 3. Mission and Impact 4. Growth in Small Business Lending The following documents should be submitted at the end of this online application: Three years of financial statements, including most recently available fiscal year Organizational chart Nominees may be asked to provide additional information upon request. For reference purposes only, a PDF version of the questionnaire can be found here Important note about completing the questionnaire! As you work, the questionnaire will save automatically, which will allow you to leave and return as long as you use the same computer and same browser and do not delete the cookies from your computer. Alternatively, you can request a dedicated link to the application, which will allow you to access your application from any computer without the use of cookies. Please contact 10ksb@ofn.org and allow 24 hours for a response. Part I. Organizational Profile Nominee Name/Organization: https://eu.qualtrics.com/controlpanel/ajax.php?action=getsurveyprintpreview&t=6vd4thepbmpievjf7zzzqo 2/7
Headquarters City and State: States and/or Regions Served: Phone: Website: Contact Information Nominee Contact Name: Title: Email Address: Phone: Name of Nominator: Relationship to Organization (i.e., funder, partner, etc) Type of Mission Driven Lender (check all that apply): CDFI Credit Union Loan Fund CDFI Bank SBA 7(a) Lender SBA Community Advantage Lender SBA 504 Lender Other Board Leadership: Please provide the name and professional affiliation of your board members (e.g., Joseph Miller, EVP of XYZ Bank). Management Team: Please provide the names and titles for your management team (e.g., Carla Garcia, CEO). Part II. Financial Performance and Sustainability Key Financial Data: Complete the following chart to include data for year to date and also three previous fiscal years. Please enter the numbers without any symbols, decimals, or punctuation (e.g., 10000). 2015 YTD 2014 (FY) 2013 (FY) 2012 (FY) https://eu.qualtrics.com/controlpanel/ajax.php?action=getsurveyprintpreview&t=6vd4thepbmpievjf7zzzqo 3/7
Organization Total Assets ($) Total Net Assets ($) Total Liabilities ($) Total Expenses ($) Assets Available for Financing ($) Total Earned and Contributed Revenue ($) Self Sufficiency Ratio (earned revenue/operating expenses) Aeris Rating, (enter NA if not applicable) Key Financial Data: Enter the following chart to include data for your small business lending program (may include microloans, if applicable). Small Business Lending Program Gross Loans Outstanding (#) Gross Loans Outstanding ($) Equity Investments Outstanding ($) in Small Businesses Loans Originated (#) Loans Originated ($) Delinquencies (>30 days) ($) Delinquencies (>90 days) ($) Net Charge Offs ($) 2015 YTD 2014 (FY) 2013 (FY) 2012 (FY) Does your organization engage in off balance sheet activities related to small business lending? If so, briefly explain scope and size of such activities. Part III. Mission and Impact The Small Business Leader Award Selection Committee will evaluate each nominee based upon how they fulfill their mission, primarily in underserved communities. Provide your mission statement. https://eu.qualtrics.com/controlpanel/ajax.php?action=getsurveyprintpreview&t=6vd4thepbmpievjf7zzzqo 4/7
How are you accountable to the communities or populations you serve? (Describe in 3 5 sentences) What percentage of your borrowers or end beneficiaries are low income, low wealth, or otherwise underserved? How do you track impact on low income, low wealth, or disadvantaged people and communities? What are the results? (Describe in 3 5 sentences) How do you ensure your Board and staff reflect the diversity of the community your organization serves? (Describe in 3 5 sentences) Describe other programs and activities that support your mission. Part IV: Growth in Small Business Lending The Small Business Leader Award Selection Committee will evaluate nominees based upon their demonstrated ability to significantly grow small business lending, primarily in low income and lowwealth communities. Growth is measured over three years and may be demonstrated by: Growth in loan portfolio (# and $ of loans outstanding) Growth in number of small business products and programs offered Growth in loans (#, $, products) to underserved communities, as defined by nominee Growth in loans to minority owned business and/or businesses serving minority communities With these criteria in mind, explain why your organization should receive the 2015 Small Business Leader Award for Mission Driven Lenders. Limit response to maximum 500 words. You have the option to upload your response to this question. https://eu.qualtrics.com/controlpanel/ajax.php?action=getsurveyprintpreview&t=6vd4thepbmpievjf7zzzqo 5/7
Please upload your response to the previous question (if you have not answered in the above space). Please upload the financial information for the past three fiscal years and the year to date in the following prompts 2015 Year to Date 2014 Fiscal Year 2013 Fiscal Year 2012 Fiscal Year Please upload your organizational chart Congratulations! You have reached the end of the 2015 Small Business Leader Award Application. Click on the "Submit" button to submit your questionnaire. If you are not ready to submit, do not click on "Submit". https://eu.qualtrics.com/controlpanel/ajax.php?action=getsurveyprintpreview&t=6vd4thepbmpievjf7zzzqo 6/7
Once the nominee questionnaire has been submitted, you will not be able to make any changes. The Final Deadline for online submission is 11:59 p.m. Eastern Time on July 27, 2015. https://eu.qualtrics.com/controlpanel/ajax.php?action=getsurveyprintpreview&t=6vd4thepbmpievjf7zzzqo 7/7