C-K Rotary Community Service Project New Initiative Mini-Grant Application Form

C-K Rotary Community Service Project Application New Initiative Mini-Grant

MAXIMUM $500
Application deadline: midnight April 15, 2022
You must be a not-for-profit or registered charitable organization to be eligible for this grant.
I. About Your Organization
Organization Name*
Type of Organization*

Not-for-profitRegistered charity
Registration number, if a registered charity:
Are you a new organization?*

YesNo
If yes, what was your rationale for starting it (max 50 words)?*

0/50
When was your organization established?*
Mailing Address*

Street Address

Street Address Line 2

CityProvince

Zip CodeCountry
Organization's Web Address, if applicable
What is your organization’s mandate or purpose? (max 50 words)*

0/50
What demographic does your organization serve (or would serve) in the Kingston community? (max 50 words)*

0/50
What is the structure of your organization? Who are the lead and other responsible individuals who would oversee this project? (max 100 words)*

0/100
Does your organization have an EXISTING or PAST connection with Rotary? If so, please describe (max 100 words)*

0/100
Have you received grants or other financial support from Rotary before? If so, specify granting club, year(s), amount, and purpose (max 50 words).*

0/50
Are you seeking funding for this project from other sources? If so, please indicate which ones AND amount requested. (max 50 words)*

0/50
Does your organization receive any Federal, Provincial, or Municipal funding? If yes, please indicate source, amount, and purpose. (max 50 words)*

0/50
II. Contact Person for this Grant
Contact Person's Name*

First NameLast Name
Title or Position*
Email*
example@example.com
Phone Number*

Area CodePhone Number
Lead person for this project*
Lead person's email*
example@example.com
Qualifications of person(s) in your organization attached to this project (max 100 words)*

0/100
Organization's Financial Statement if applicable (upload file)

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III. Project Information

Project must be completed within one year of funding.
Project title*
Start Date*

MonthDayYear
Date
End Date*

MonthDayYear
Date
Project Special Event if applicable
Project Special Event Date if applicable

MonthDayYear
Date
TOTAL FUNDS requested*
Main Field of Interest (choose one that most closely matches your project)*

Peace and Conflict ResolutionDisease Prevention and TreatmentProviding clean water, sanitation, and hygieneMaternal and Child HealthSupporting educationEconomic and Community DevelopmentPreserving the environment
Project Budget (upload spreadsheet) Please provide a specific breakdown of your needs and costs.*

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Project Description

In each of the following sections, please ensure that you address each question asked.
Project Purpose (max 250 words): a. What needs are you addressing and how were they assessed? b. Who will benefit most from the project? In what way? c. How will your organization benefit? d. How do you justify this particular project at this particular time?*

0/250
Project Impact (max 250 words). a. What results are you expecting? b. How many people will benefit from your project? c. How will you measure the success of your project? d. How might you build on this project in the future?*

0/250
Tell us about your project (max 250 words). a. What do you want to accomplish, i.e., your GOALS? b. How will you carry out your project? b. What people, materials, and services are required? *

0/250
Project*
Connections with the Rotary Club of Cataraqui-Kingston
How does the project fit with Rotary values and priorities? (Refer to Guidelines) (max 50 words)?*

0/50
How might our Rotary Club and its members work hands-on with you on the project (max 50 words)?*

0/50
Please acknowledge that you are aware that the final step before acceptance may require an in-person or online presentation to discuss the project.*

Yes
Please acknowledge that a final report and financial statement to the Club will be required not later than 12 months following receipt of this grant. Please include all relevant documents (e.g., copies of receipts, purchase orders, etc.). Photos would be appreciated!*

Yes
Support documents (optional), maximum 2 pages, including letters of support and images; combine as a single pdf file

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IV. Submission
Signature of Applicant*

Clear
If you wish to print the form, together with the content you have entered, press "Print form" before pressing "Submit."

Are you sure you're ready to submit? Before pressing "Submit," please make sure that everything is correctly completed. You will not be able to make changes or additions after you have submitted your application.

If your submission was not allowed, then check to see that you have provided all required information. Required fields are marked with an *.

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C-K Rotary Community Service Project Application New Initiative Mini-Grant

Application deadline: midnight April 15, 2022

I. About Your Organization

II. Contact Person for this Grant

III. Project Information

Project Description

Connections with the Rotary Club of Cataraqui-Kingston

IV. Submission