Rangiora Lions Club - Funding Request Application

Rangiora Lions Club - Funding Request Application
Thank-you for starting an application for funding from the Rangiora Lions Club.

Lions is the world's largest community service organisation and our club members enjoy 'giving back' to the local North Canterbury community, in time and through money raised from projects.

Please read the Lions Club of Rangiora Charitable Trust's Deed to understand the types of causes and groups within our community we support financially.

We appreciate you taking the time to contact us and hope we can assist you with your goals.
OrganisationIndividual
* Your Organisation's Name*
Sports ClubCultural GroupSchoolCommunity SupportOther
* Your Name
* Your Email Address
example@example.com
* Phone Number
* Sum requested*
Amount you are applying for ($)
* Your Project - how will the funding be used ?
Itemise costs if possible. If the activity ISN'T going to be based in New Zealand, please include details here.
* Number of people who will benefit from this funding request (if successful)
Note: Rangiora Lions prefers to support requests that will assist a number of people
* Have you done any other fundraising for this Project?
* Bank Details - payment is made by bank transfer (if funding request is successful)
To the best of my knowledge and belief, the above information is true and correct.

I understand that any funds granted as a result of this funding application may only be used for the purpose outlined in this application and that if the funds are used for any purpose not specified in the application, I will be required to return the funds to the Lions Club of Rangiora.
* Name / Signature
* Date

DayMonthYear
NoYes
Parent / guardian name or signature (if applicant is under 18 years old)
* Any other information you'd like to include (optional)
Should be Empty: