FUNDING REQUEST APPLICATION

FUNDING REQUEST APPLICATION
Detroit Lakes (MN) Noon Rotary Club
Requests must adhere to at least one of the six Rotary focus areas: promoting peace, fighting disease, providing clean water, saving mothers and children, supporting education, growing local economics
Requesting Organization:
Name
Address
Telephone
Email
example@example.com
Contact Person and Position in the Organization
501C-3 Qualification

YesNo
Mission Statement and Description
(Please use an attachment if additional space is required for any of the below responses)
Request:
Amount
Date

MonthDayYear
Date
Describe the project and how funding will be used and who will benefit from the funding
What is the time line for the project and when will funding be used?
Amount Requested
Total Project Cost
Dollars Pledged To Date

MonthDayYear
Date
Other Funding Avenues Pursued
Rotary Club Official Use Only
Should be Empty: