broadcom foundation online application eligibility … foundation online application eligibility...

Communities where Broadcom communities are located:

NORTH AMERICA • Irvine, California (Corporate Headquarters) • Andover, Massachusetts - Brickstone Square • Andover, Massachusetts - Federal Street • Austin, Texas • Bellevue, Washington • Burlington, Massachusetts • Chicago, Illinois • Colorado Springs, Colorado • Duluth, Georgia • Edina, Minnesota • Federal Way, Washington • Fort Collins, Colorado • Germantown, Maryland • Glen Rock, New Jersey • Houston, Texas • Lancaster, Pennsylvania • Longmont, Colorado

• Markham, Ontario • Marlborough, Massachusetts • Matawan, New Jersey • Morrisville, North Carolina • Nashua, New Hampshire • Petaluma, California • Point-Claire, Quebec • Richmond, British Columbia • San Diego, California • San Jose, California - S. Bascom Avenue • San Jose, California - Zanker Road • Santa Clara, California • Seattle, Washington • Sunnyvale, California • Tempe, Arizona • Yadley, Pennsylvania

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Broadcom Foundation Online Application Eligibility Questions

EEMEA • Athens, Greece • Bracknell, United Kingdom • Bristol, United Kingdom • Bunnik, Netherlands • Cambridge, United Kingdom • Copenhagen, Denmark • Gent, Belgium

• Mechelen, Belgium • Ramat Gan, Israel • Sophia Antipolis, France • Venture House, United Kingdom • Yakum, Israel • Yehud, Israel

ASIA PACIFIC • Bangalore, India • Beijing, China • Hsinchu, Taiwan • Hyderabad, India • Shanghai, China - West Nanjing Road • Shanghai, China - Daduhe Road

• Shenzhen, China • Singapore • Seoul, Korea • Taipei, Taiwan • Tokyo, Japan

AUSTRALIA • Sydney, Australia

Qualified Entities

• Qualified U.S.- based tax-exempt public 501(c)(3) charities with high-quality programs and services, well- defined goals, a proven record of maximizing available resources, and a reputation for meeting objectives and reporting measured results.

• Governmental entities (public universities, public schools, etc.). • Organizations not recognized as a 501(c)(3) public charity or as a government entity (i.e., foreign organizations, Non-

Governmental Organizations (NGOs) and/or private foundations) may be considered if invited to apply by the Foundation.

Broadcom Foundation will NOT entertain requests for gifts from the following entities: • Individuals • For-profit entities • Fraternal, labor, political or social organizations • Political parties or candidates • Sectarian religious organizations • Private schools K-12 • Trade or business associations • Organizations that are not publicly -supported charities exempt from tax under IRC section 501(c)(3) • Organizations that discriminate on the basis of race, religion, creed, gender, national origin, or other similar factors

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Broadcom Foundation will NOT entertain requests for gifts for the following activities:

• Advertising journals, booklets, etc • Any purpose that directly benefits Broadcom

Corporation or a Broadcom employee • Capital campaigns (unless initiated by Broadcom

Foundation) • Congresses, symposiums, and meetings • Individual or family requests for scholarships, financial

assistance or other types of support • Lobbying • Technical research in support of Broadcom products • Political candidates, campaigns and activities

• Sporting events (tickets and sponsorships) • The benefit of any particular individual, including

individual travel and/or study • Travel expenses • Trips, tours or cultural exchange programs • University administrative, management or indirect

fees • Organizations that collect funds for redistribution to

other nonprofit groups • Contributions in the name of a memorial tribute

Funding is generally NOT approved for: • Endowments, capital or building campaigns • Regular, ongoing, operating support • Agencies, projects or programs normally financed by

government sources • Contingencies, deficits or debt reduction

• Contributions in the name of a memorial tribute • Special fundraising event table or ticket purchases

(i.e., dinners, walks, runs, rides, etc.) • Matching gifts

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Organization Information Contact Information Project Information Attachments * Required Fields

Printable Version

General Organization Information

* Organization Legal Name

0 of 255

Tax ID / EIN (for US organizationsonly)

ValidateUnknown Organization

* Address

0 of 255

Address 2

0 of 255

* City

0 of 64

* State

0 of 2

* Postal Code

0 of 10

* Country

0 of 255

* Telephone

0 of 32

Fax

0 of 32

Web Site

0 of 255

Broadcom Foundation Online Application

Organization Details

* MissionStatement:Provide a verybrief missionstatement for theorganization.

* Organization'sHistory: Pleaseprovide a briefhistory of yourorganization.

* Organization'sGoals: Please listthe goals of yourorganization.

To Save Your Application

If at any time you'd like to leave this form and save it in progress, please click on the Save Draft button andfollow the instructions. You will be prompted to enter your email address and the system will then send you aweb-link that you can use to resume your form at a later time.

Technical Assistance

Should you have technical questions regarding the online submission process, please contact BroadcomFoundation's administrator, Foundation Source, at (800) 839-1754 or [email protected], andthey will be happy to assist you.

To view more of our Frequently Asked Questions, please click here to open them in a new window.

Save Draft Submit Next



Printable Version

Primary Contact Information**The primary contact should be the person responsible for questions regarding this application.

* Salutation (Dr., Ms., Mr., etc.)

0 of 32

* First Name

0 of 255

* Last Name

0 of 255

* Title/Position

0 of 64

* Contact Phone

0 of 32

Fax

0 of 32

* Email

0 of 255


If at any time you'd like to leave this form and save it in progress, please click on the Save Draft button andfollow the instructions. You will be prompted to enter your email address and the system will then send you aweb-link that you can use to resume your form at a later time.



Printable Version

Project Information

* Project Name

0 of 50

* Requested Funding Amount (Max$2,500)

0 of 15

* Total Project Budget

0 of 15

* Which of the Eligible Non-ProfitEntities does your organizationrepresent?

STEM Education (Universities)STEM Education (Grades K-12)HealthHuman ServicesOther

If other, please explain in a singlesentence

0 of 255

* Which of the following Areas orGoals does your Project fall into?

Graduate and post-graduate STEM research, scholarship andinnovation

Undergraduate STEM educationInnovative Programs in K-12 STEM education with application in

communities where Broadcom employees live and workCommunity STEM Programs located communities where Broadcom

employees live and work.Closing the STEM education gap among women and ethnic and

minority populationsCommunity programs and services where Broadcom employees live

and work

* Please brieflydescribe yourProgram orBr


Project for whichyou seek funding?

0 of 500

* Please describeProject'snecessity and thetarget populationit addresses

* What are theintendedoutcomes of yourProject?

* What are theProject evaluationmethod andtools?

* Please describeyour long-termplan forsustainability orscalability

* Please upload your timeline,including Project/Programscheduled benchmarks

No file chosenChoose File Attach File(No file has been attached.)

* Please provide the line itembudget of the project for whichyou are seeking funding


* Please list alladditionalsources forfunding of Project

* From time to timeBroadcomCorporationmakes in-kinddonations of usedequipment. Doesyour projectrequireequipment, ifavailable, and ifso, please stateBrB


your specificneeds.

* Do Broadcom employeesvolunteer with your organization?

Yes No

If yes, pleaseindicate anyBroadcomemployees thatserve on yourboard orcommittees

Please state anyvolunteeropportunities forBroadcomemployees in thisproject or in yourorganization ingeneral


If at any time you'd like to leave this form and save it in progress, please click on the Save Draft button and follow theinstructions. You will be prompted to enter your email address and the system will then send you a web-link thatyou can use to resume your form at a later time.

Technical Assistance

Should you have technical questions regarding the online submission process, please contact BroadcomFoundation's administrator, Foundation Source, at (800) 839-1754 or [email protected], and theywill be happy to assist you.

To view more of our Frequently Asked Questions, please click here to open them in a new window.

Previous Save Draft Submit Next



Printable Version

Attachments

Please attach the following files by clicking the "Browse" button, finding your file, and clicking "Attach File".

* Most recent Annual Report No file chosenChoose File Attach File(No file has been attached.)

* Annual Budget No file chosenChoose File Attach File(No file has been attached.)

* List of the Governing Board No file chosenChoose File Attach File(No file has been attached.)

* List of Key Staff MembersNo file chosenChoose File Attach File

(No file has been attached.)

* Short Summary about ProjectDirectors No file chosenChoose File Attach File


* Organization's most recentAudited Financial Statements; ifAudited Statements are notavailable, Internal Statements witha copy of the most recent 990Form should be submitted


Supporting Documents forProposal, if any No file chosenChoose File Attach File

