Grant/Sponsorship Request Form

Request for Grant/Sponsorship

Rotary Club of Gibsons
Your Name*

First NameLast Name
Your Organization's Name*
This will be used as Payee if we issue a cheque
Mailing address (This is where we will send the cheque if approved)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
E-mail*
example@example.com
Phone Number*
Amount requested ($)*
Note that grants are normally in the range $200 - $2000 max
Title and brief description of your request*
Note - you may append a PDF document - see box at the end of this form

Are you requesting any other input to this project from Rotary eg volunteer hours?
Give brief details of the nature of the voluntary work requested - eg "Interior painting - 40 hours"
Are there any other Community Partners involved in this project?
Please give names of other Community Partners, both applied for and granted
Who will benefit from this Grant/Sponsorship?
Estimate the number of beneficiaries and say how they will benefit
How will Rotary's contribution be recognized?
Eg Press coverage, logo on website, permanent signage etc
Signature

Clear
Date

MonthDayYear
Date
Upload a PDF file to support your application. Drag and drop here.

Request for Grant/Sponsorship