GRANT APPLICATION
It is the mission of Rotary to Serve Above Self, and to support organizations in our community that do good work and follow the same mission! Thank you for desiring to partner with us on your project. We're already excited to learn about your project and we're hopeful we can help! Please fill in the form below.
Contact Information
Full Legal Organization Name
Organization Website
Are you working under a DBA?
Employer Identification Number (EIN)
*
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Organization President / Executive Director
First Name
Last Name
Title
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
E-Mail Address
example@example.com
Contact Person
First Name
Last Name
Title
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
E-Mail Address
example@example.com
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Organization Information
501(c)(3)?
Yes
No
Year Established
Fiscal sponsor name
Fiscal sponsor address
How often does the governing body meet?
Monthly
Quarterly
Annually
We do not have a governing body
Other
Total Organization Budget
Total # of Board Members
Total # of Paid Staff
Total # of Volunteers
How long has the organization operated in Rutherford County, TN?
Does the organization have a written constitution or bylaws? *
Please Select
Yes
No
I Don't Know
Does the organization operate on a calendar year or fiscal year?
Calendar Year
Fiscal Year
I Don't Know
Organizational Mission Statements
Brief Description of Organization
Population Served
How many people or families were served in the last accounting year?
Does any member of the Murfreesboro Breakfast Rotary Club (MBRC) work with the organization or sit on their board? If so, who?
Has MBRC or MBRCF made a contribution to this organization?
Please Select
Yes
No
I Don't Know
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Proposal Request
Program / Project Name
Describe intended use of contribution:
Total Program Budget
MBRCF Requested Amount
MBRCF Percent of Total Budget
What are other sources of funding? (Enter N/A if Not Applicable)
How much did you receive from other fund raising projects last year?
Grant Period From
-
Month
-
Day
Year
Date
Grant Period To
-
Month
-
Day
Year
Date
Multi-Year?
Yes
No
Would a member of the organization be available to arrange a presentation to the club?
Please Select
Yes
No
I Don't Know
Most recent grants received from this funder:
Describe previous funds received from MBRC and the use from the most recent year
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