Donation Request Form

Donation Request Form

Rotary Club of Plattsburgh Sunrise
Mission

The mission of the Sunrise Rotary Club of Plattsburgh is to make a positive impact in the lives of our members and within our communities by providing opportunities for service and leadership at the local and international levels. We achieve this through a committed, diverse, and knowledgeable membership made stronger through project work, fellowship, and fun.

Avenues of Service

The Sunrise Rotary Club of Plattsburgh is committed to service at home and abroad through the five Avenues of Service, which are the foundation of our club activities:

• Club Service
• Vocational Service
• Community Service
• International Service
• Youth Service

The Sunrise Rotary Club of Plattsburgh supports programs in our local community and around the world that reinforce our Mission and Avenues of Service.

The Sunrise Rotary Club of Plattsburgh typically does not contribute to individuals, religious or political affiliations, general operating budgets, or organizations, groups, or events that already have a major funding source or raise funds to support another institution.

Requests for charitable contributions are accepted year-round and will be reviewed twice a year, on:

• November 1
•April 1

You will be notified in writing when a decision regarding your request has been made.

Please note that approved contributions must be utilized within twelve months following the approval date. If the contribution is not utilized within that timeframe, the Board of Directors reserves the right to request that the entire contribution be returned to the Club.
Date Of Request

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
ORGANIZATION INFORMATION
Name
Website
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Sunrise Rotary Past Support
If yes; when & amount.
INDIVIDUAL CONTACT INFORMATION
Name

First NameLast Name
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
PROJECT DESCRIPTION • Include the exact dollar amount of contribution if applicable and provide additional documentation if necessary:
Means of Recognizing Rotary:
Additional Information (optional)

Cancelof
Are you willing to speak about your organization at a meeting?
Please note the Small Contributions Committee reviews applications twice a year. November 1st and April 1st.

Plattsburgh Sunrise Rotary Club • PO BOX 1183, Plattsburgh, NY 12901
PlattsburghSunriseRotary.org

Meetings 7:30 AM • PSUC Au Sable Hall, or on Zoom. See our website for the meeting schedule. THANK YOU!
Should be Empty:

Donation Request Form

ORGANIZATION INFORMATION

INDIVIDUAL CONTACT INFORMATION

Please note the Small Contributions Committee reviews applications twice a year. November 1st and April 1st.

PlattsburghSunriseRotary.org