New Jersey Social Impact Investment Fund (SIIF) Interest Form

Welcome

Thank you for your interest in the New Jersey Social Impact Investment Fund (SIIF) Early Childcare initiative!

The New Jersey Department of the Treasury has selected Nonprofit Finance Fund (NFF) to serve as the fund manager for the NJ SIIF, the state's first socially driven public finance vehicle. The SIIF will provide loans at affordable rate loans for new construction, renovation and/ or expansion of a licensed childcare or Pre-Kindergarten facility.

By submitting this form you acknowledge and agree that the responses provided to NFF may be shared with the New Jersey Economic Development Agency (“NJEDA”) and the Division of Early Childhood Education and the NJ Department of Treasury. If you have any questions regarding your application, please contact us at NJSIIF@nff.org.

After you submit this form, we will be in touch to discuss your request.

Organization Information

Contact Information

First Name

Last Name

Title

Role at organization

Phone

I would like to join NFF's mailing list for occasional updates and social sector insights.

Organizational Information

Organization/Company Name

Website

City

Headquarter City

State

Headquarter State

Zip Code

Headquarter Zip Code

Has your organization been in operation for a minimum of 3 years?

YesNo

Year Organization Founded

Please enter the full year: "YYYY"

Please select the entity type of your organization.

Non-profit 501(c)(3)Other tax-exempt nonprofit organizationLimited Liability Company (LLC)Mission-driven for-profit organizationC-CorporationS-CorporationSole ProprietorshipSpecial Purpose Entity / Single Purpose EntityJoint Venture / PartnershipPublic Agency / Government EntityTribal EntityOther

Other

In what sector does your organization primarily work? Please check the one that aligns with your organization's NTEE code.

NTEE: National Taxonomy of Exempt Entities

Are you licensed by New Jersey Department of Children and Families (NJCDF)?

YesNo

Are you currently enrolled or plan to enroll at least one (1) child receiving support through the New Jersey Department of Human Services (NJDHS) Child Care Assistance Program?

YesNo

Organizational Financials

Has your organization generated net profit or operating surplus in two of the last three years?

YesNo

What was your total annual operating expense for the last complete fiscal or calendar year? If you did not have an operating expense budget last year, put '0'. An estimate or rough approximation is fine.

$0-$250,000$250,001-$750,000$750,001-$1,000,000$1,000,001-$2,000,000$2,000,001-$5,000,000$5,000,001-$10,000,000$10,000,001-$20,000,000Greater than $20,000,000

Does your organization or project have secured funding streams (e.g. executed grants, contracts, leases, contributions and other revenues) and identified reliable sources of repayment for the loan?

YesNo

Does your organization have annual CPA-prepared or audited financial statements?

YesNoCPA-prepared audited financial statements are annual financial reports that have been independently reviewed and certified by a licensed Certified Public Accountant (CPA) to ensure accuracy and compliance with accounting standards. This is different from internally prepared financial statements or CPA-reviewed or compiled statements and requires a formal audit conducted by an independent CPA.

Are you expecting an audit to be completed in the next few months, or has the organization completed an audit in the recent past, or can you provide compiled or reviewed financial statements?

YesNo

Has your organization ever had a loan before, from any lender?

YesNo

Financing Needs Details

Financing Needs

Loan amount requested:

Please do not include any symbols or commas in your response.

Proposed use of proceeds:

AcquisitionEquipment and TechnologyLeasehold ImprovementsNew ConstructionPermanent FinancingPredevelopmentRenovation of an Owned FacilityWorking CapitalRefinance Other DebtOther

Other

Please provide more detail on your loan request and the intended use of the proceeds.

Project Address

If the financing is for a specific real estate project, will the project location be different from the organization address provided above?

YesNo

Project Street Address

Project City

Project State

Project Zip/Postal Code

Populations Served

Approximately what percentage of your clients, during the last fiscal year, qualified as low-income?

Please provide a brief description of the company/organization's program(s) or services.

Provide a brief description of the population(s) you will serve using the requested financing from the NJ SIIF.

How did you hear about the NJ SIIF?

Referral from an NFF clientReferral from another lender (e.g., CDFI, Bank, Credit Union) Referral from a partner organization (e.g., foundation, consultant, OFN’s CDFI locator)NFF staff or Board memberNFF workshop, webinar, or other event (e.g., conference presentation)NFF marketing materials (e.g., annual report, one-pager, research report)NFF National State of the Sector SurveyNFF website via web search (e.g., Google, AI)Social Media (LinkedIn, BlueSky, YouTube)News article Other

Other (please specify):

(Optional) Name referral source

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