Grant Application
Section 1: Organization Information
Organization Name
*
Mailing Address
*
Website
*
Name of Executive Director/CEO
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Primary Contact for the Project
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Tax ID (EIN)
*
IRS Letter
*
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Most Recent 990
*
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Year Founded
*
Mission Statement
*
Brief History of the Organization (limit 100 words)
*
0/100
Section 2: Project Overview
Project Title
*
Amount Requested from Rotary Club
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Total Project Budget
*
Project Start Date
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Month
-
Day
Year
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Project End Date
*
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Month
-
Day
Year
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Geographic Area Served (must include residents of Tarrant County)
*
Brief Summary of the Project (limit 100 characters)
*
0/100
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Section 3: Project Details
Statement of Need: What community issue does this project address? (limit 150 words)
*
0/150
Project Description: Goals, Activities, Timeline
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Target Population: Who will benefit and how many (limit 100 words)
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0/100
Expected Outcomes and Impact (limit 150 words)
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0/150
How will success be measured? (limit 150 words)
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0/150
How does the project align with Rotary's Areas of Focus for the Endowment, Veteran's or Children's Fund? (limit 100 words)
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0/100
Does the project align with the giving priorities of the Club's funds?
*
A Club Committee supports the project
Offers financial leverage on endowment's contribution that can be documented
A member of the Club works at the Organization
A member of the Club sits on the organization's board
Name(s) of Club Committee or Club members
*
Section 4: Budget
Upload Budget Template (available of Club website)
*
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For Requests of >$7,500: How will the project be sustained after Rotary funding ends?
Section 5: Organizational Capacity
List Key Staff and Roles
*
For requests >$7,500: Describe past projects or partnerships that demonstrate experience in carrying out similar projects (limit 250 words).
0/250
List of Board of Directors
*
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Copy of most recent audit, financial review, or financial statments
*
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Section 6: Declarations and Signatures
Name
*
First Name
Last Name
Title
*
Date
*
-
Month
-
Day
Year
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