District 6910 District Grant Application

District 6910 District Grant Application

DISTRICT 6910 GRANT APPLICATION
Project name:Click here to enter text.
Rotary club name:Click here to enter text.
Project objective(Describe the measurable outcome of the project):
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Which AREAS OF FOCUS are addressed by this project?
☐Peace/Conflict Resolution☐Disease Prevention/Treatment☐Water and Sanitation
☐Maternal and Child Health☐Basic Education and Literacy☐Economic/Community Development
Community or neighborhood served(Describe the geographic and demographic community being served by this proposed project):
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Number of beneficiaries:Click here to enter text.
Project beginning date: Click here to enter a date.Project ending date: Click here to enter a date.
SUSTAINABILITY
Skill and knowledge transfer (Describe the skill or knowledge transferred, if any):
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Expendable supplies (Are there expendable supplies? If so, how will they be replaced?)
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Maintenance (Is there equipment to be maintained? If so, how will this be addressed?)
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PARTNER ORGANIZATION
Is there a partner organization involved?☐YES☐NO
If a partner is involved, name of organization:Click here to enter text.
If a partner is involved, describe the partner's involvement:
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ROTARY INVOLVEMENT
Rotary Clubs involved in the project.
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Number of Rotarians involved in the project: Click here to enter text.
Describe Rotary's and Rotarian involvement in the project
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PROJECT BUDGET
Labor / $Dollars.Cents
Supplies and Materials / $Dollars.Cents
Equipment / $Dollars.Cents
Other / $Dollars.Cents
TOTAL / $Dollars.Cents
Amount of Grant Request(Not to exceed 50% of project budget):$Dollars.Cents
Amount supplied by Rotary Club(s) and others: $Dollars.Cents
ROTARY CLUB CONTACTS
Contact 1 Name / Telephone / Email
Click here to enter text. / Click here to enter text. / Click here to enter text. /
Contact 2 Name / Telephone / Email
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Copies of receipts must be submitted with the final report. Original receipts for all expenditures must be retained by the club for three years. Approved expenditure receipts must equal the grant amount. Club will be responsible for reimbursing to the District Foundation any difference.
Receipts for all expenses will be due at the time of filing the final report and will be retained for at least three years and made available for auditing purposes. The final project report will be due to the District DSG Chair no later than 45 days after project ending date.
Failure to comply with the terms of the Grant may result in the club being financially responsible for refunding the amount of the Grant. Understand and accept the terms of the Grant requirements. Do not accept the terms of the Grant requirements.
By signing this grant request, I confirm that our Rotary Club is requesting a District Grant in the amount above will be spent in accordance with Trustee approved guidelines and the Terms and Conditions of Matching Grant Awards. All of the information contained herein is true and accurate
Club President Elect ______Date: ______
Rotary Club of ______

Submit grant application to District Grants Coordinator, Joanne Tolleson: , 678.341.6640