Rotary Club of Fort Worth Two Year Grant Application

Rotary Club of Fort Worth Two Year Grant Application
About this application: • Use this form for projects requesting sustained Rotary Club of Fort Worth funding across two consecutive years. • Funds are available from the Club's Children's Fund. Qualifying projects are any benevolent, charitable, educational, or research undertaking, with particular emphasis on the medical, educational, and other needs of children. • Maximum request: $100,000total, disbursed as up to $50,000 in Year 1 and up to $50,000 in Year 2. • Year 2 funding is not automatic. It is contingent on Board approval of an interim report submitted after Year 1 (see Section 7). • For single-year requests of $50,000 or less, use the standard one-yearGrant Application instead.
Section 1: Organization & Contact Information
Organization Name
Mailing Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Website
Executive Director/CEO - First Name
Executive Director/CEO - Last Name
Organization Address - Street Address
Organization Address - Street Address Line 2
Organization Address - City
Organization Address - State / Province
Organization Address - Postal / Zip Code
Primary Contact for the Project - First Name
Primary Contact for the Project - Last Name
Primary Contact Email Address
example@example.com
Primary Contact Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Primary Contact Address - Street Address
Primary Contact Address - Street Address Line 2
Primary Contact Address - City
Primary Contact Address - State / Province
Primary Contact Address - Postal / Zip Code
Tax ID (EIN)
Year Founded
Section 2: Organizational Background
Mission Statement: 100 word limit

0/100
Brief History of the Organization: 250 word limit
Upload IRS 501c 3 Letter

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Upload Most Recent Audit or Financial Statements

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Upload List of Board Members

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Section 3: Project Overview
Project Title
Brief Summary of the Project: 250 word limit

0/250
Total Amount Requested from Rotary Club
Year 1 Amount Requested
Year 2 Amount Requested
Total Project Budget
Other Sources of Funding for this Project: List funding source, amount of funds, when funds will be received
Project Start Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Project End Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Geographic Area Served Includes:
Section 4: Project Narrative & Outcomes
Statement of Need
Project Description: Goals, Activities, Timeline
Year 1 Milestones & Deliverables
Year 2 Milestones & Deliverables
Target Population
Expected Outcomes and Impact
How will success be measured?
How does the project align with Rotary's Areas of Focus for the Children's Fund?
Section 5: Alignment with Rotary Priorities
Alignment with giving priorities
Name(s) of Club Committee or Club members
Upload letter of support from Club Committee if applicable

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Section 6: Budget Breakdown
Year 1 - Personnel
Year 1 - Materials & Supplies
Year 1 - Equipment
Year 1 - Other (specify)
Year 1 - Total
Year 2 - Personnel
Year 2 - Materials & Supplies
Year 2 - Equipment
Year 2 - Other (specify)
Year 2 - Total
Two-Year Total - Personnel
Two-Year Total - Materials & Supplies
Two-Year Total - Equipment
Two-Year Total - Other (specify)
Two-Year Total - Total
Budget Narrative: Provide a detailed, line-by-line explanation of every expense listed in the Budget Breakdown table above. For each line item, describe what the funds will be used for, how the cost was estimated (e.g., vendor quotes, past invoices, market rates), and how the expense directly supports the project's goals and activities described in Section 6. Clearly distinguish Year 1 costs from Year 2 costs and explain any significant differences between the two years. If an expense will be shared with other funding sources, state what portion Rotary funds will cover. Round dollar amounts should tie back to the totals in the Budget Breakdown table.
Section 7: Sustainability, Capacity, and Oversight
Sustainability Plan: How will the project be maintained after the grant period?
Key Staff and Roles
Past Projects or Partnerships: Provide examples of similar projects completed
Financial Oversight
Section 8: Certification & Authorization
Authorized Signer First Name
Authorized Signer Last Name
Authorized Signer Title
Signature Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Certification - Information is true and accurate
Certification - Understanding of Year 2 funding contingency
Should be Empty:

Rotary Club of Fort Worth Two Year Grant Application

Section 1: Organization & Contact Information

Section 2: Organizational Background

Section 3: Project Overview

Section 4: Project Narrative & Outcomes

Section 5: Alignment with Rotary Priorities

Section 6: Budget Breakdown

Section 7: Sustainability, Capacity, and Oversight

Section 8: Certification & Authorization