2025 Annual Community Grants Application Form

2025 Annual Community Grants Application Form
Applicant Information
Organization Name*
Address*

Street Address (not PO Box)

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter main phone number.
Email*
example@example.com
Website*
Social profile(s)*
List social media profiles
Executive Director*

First NameLast Name
Executive Director’s Email*
example@example.com
Primary Contact*

First NameLast Name
Primary Contact’s Phone Number*
Please enter best contact number.
Primary Contact’s Email*
example@example.com

Organization Information
Organizational Mission Statement*

0/75
Brief description of Organization*

0/150
Current Annual Operating Budget*
Geographic Area Served*
Please choose one
Demographic focus*
What population do you serve?
Year Organization founded*
Date 501(c)(3) established*

MonthDayYear
Please include copy of IRS determination letter.
File Upload: IRS determination letter 501(c)(3) status *

Cancelof

Project Proposal

Tell us about your project.
Project Name*
Project Timeline: Start date*

MonthDayYear
Date
Project Timeline: End Date*

MonthDayYear
Date
Total Estimated Project Funds*
Requested Grant Funds*
Please include a proposed project budget
File Upload: Proposed Project Budget*

Cancelof
Have you received other grants or funding for this project?*
If ‘Yes”, please specify total amount to date.
Have you applied/Will you apply for other grants and/or funding for this project?*
If ‘Yes’, please list sources and amounts.
Rotary International’s motto is ‘Service Above Self’. Which of the 7 Rotary Focus Areas of Service does your project best represent?*

Basic Education & LiteracyCommunity Economic DevelopmentDisease Prevention & TreatmentMaternal & Child HealthPeace & Conflict ResolutionSupporting the EnvironmentWater, Sanitation & Hygiene
Please give a brief general overview of your project, sharing a few main goals and objectives.*

0/250
Briefly describe how you identified this need in our community. How will your organization use Rotary grant funds within this project?*

0/250
Community Partnerships: List other agencies or volunteer groups that will partner with you in this project; describe the nature and extent of their participation.*
Please submit a letter of participation from each agency/group involved.
File Upload: Letter(s) of Participation *

Cancelof
Describe how you will evaluate data results and report the outcomes of your project.*

0/150
Why does your organization believe the Rotary Club of Front Royal should be involved with your project? Describe how you plan to promote your project. Share how you plan to recognize our club for the grant award and partnership.*

0/200
Please list 3 ways the Rotary Club of Front Royal would be able to serve with this project?*
Is there any other information you’d like to share?

Project Authorization & Grants Results Certificate - Organization Officer Signature Section

REQUIRED FOR ALL APPLICANTS
By signing below, (Organization name)* accepts responsibility for:

A. Completing an Interim Progress Report for email submission to the Rotary Club of Front Royal NO LATER THAN September 15, 2025.

B. Completing a Final Results Report, including a final project expense report, for email submission to the Rotary Club of Front Royal NO LATER THAN April 30, 2026.

C. Acknowledgement that any grant funds that are: not spent in accordance with the grant guidelines; without invoices, receipts or proof of payments; and/or unused at expiration of the grant period will be surrendered by the organization and returned to the Rotary Club of Front Royal.

D. Acknowledgement that the Rotary Club of Front Royal reserves the right to: request additional project or organization information; and/or suggest and allow for special conditions in the acceptance of the application.

E. Acknowledgement that the organization’s governing board has reviewed and understands the Annual Community Grant Guidelines and has authorized this application.

Authorization: The organization’s signing officers both agree that all information in this application is accurate and true to the best of their knowledge, and that their organization has agreed to undertake this project. In the event they receive a grant from the Rotary Club of Front Royal, they agree that all funds will be used exclusively for this project, and to be held accountable and compliant with the terms and conditions set forth in the Annual Community Grant Guidelines. Noncompliance with any part of this agreement will result in revocation of this grant and forfeiture of awarded funds.
Organization’s Primary Officer - Name*

First NameLast Name
Organization’s Primary Officer - Signature*

Powered by Jotform SignClear
Date*

MonthDayYear
Date
Organization's Secondary Officer - Name*

First NameLast Name
Organization’s Secondary Officer - Signature*

Powered by Jotform SignClear
Date*

MonthDayYear
Date

Grant Application Checklist
Please review before you submit. Incomplete applications will not be considered.

1. Completed application form

2. Project budget proposal uploaded

3. IRS determination letter of 501(c)(3) status uploaded

4. Letter(s) of participation for all community-partners agencies uploaded

5. Project Authorization & Grant Results Certificate

Thank you for your application. We will be in touch soon!
Should be Empty:

2025 Annual Community Grants Application Form

Applicant Information

Organization Information

Project Proposal

Project Authorization & Grants Results Certificate - Organization Officer Signature Section

Grant Application Checklist