FUNDING REQUIREMENTS FOR 2015- 2016

Clubs must have obtained the following minimum per capita of TRF Annual Giving to receive a District InternationalGrant Award:

2015– 2016 projects: $30 combined per capita giving to the Annual Fund and Polio Plus for 2014-2015.

Thesponsoring club (usually a District 7170 Club) and the host club must contributefundstoward the project in order to receive District 7170 International Grant funds.

Projects will receive grant reimbursement when the project is complete and the final report has been submitted (if this presents a hardship to your club, please see Section 5, item 3a.)

1. THE PROJECT

Project Name______

(Brief Descriptive Title)

Amount of District Funds Requested $ ______

(Minimum $1,000.00, maximum $5,000)

Amount of sponsoring club funds $______

Amount of host club funds $ ______

Other funds $______

Total budget for this project $______

(Minimum $1,000.00, maximum $5,000)

D7170 Sponsoring Rotary Club: ______

Club Number ______

(This is the Club in District 7170 that is initiating the project and is seeking funds from the District)

Primary Contact and Project Implementation Committee Chair’s name at sponsoring Rotary Club:

______

(Please Print)

Full Postal Address: ______

Home Tel: ______Business Tel: ______Email: ______

Per Capita Annual Giving by the club in the prior year $______

Name of the club member who attended the District 7170 Grants Management Seminar, ______and date of the seminar ______.

2. DESCRIPTION OF PROJECT PROPOSAL

Attach a typed project description (maximum 2-3 pages) describing the proposed project under all of the following seven numbered headings:

  1. Proposed Project - summarizing goals and deliverables
  2. Implementation Plan – timeline for implementation
  3. Rotarian Involvement – how will Rotarians both international partner (D7170) and host club be involved in this project.
  4. Ownership - who will be the final owner of any project equipment/materials/supplies? (cannot be a Rotary Club or Rotarian)
  5. Sustainability – Describe how the project will be maintained and sustained after the grant has ended.
  6. Expenditure Budget - a total project expenditures budget, detail all expenses. Provide pro forma invoices or catalog prices for all supplies, equipment and services.
  7. Revenue Budget - a total project revenue budget (list funding sources and proposed amount of club funds, along with the amount of requested DistrictInternational Grant funds)
  8. Start Date - estimated start date of the project
  9. Completion Date - estimated completion date of the project(project must be completed within 12 months)

3. Host Club

(The host club is the club that will be executing the project)

Name of the Club ______Club Number ______

District ______

Club President:

Name: ______

Postal Address:______

Home Tel:______

Business Tel:______

Email:______

A Host Club Project Implementation Committee of at least three Rotarians must be established for the project. It is the Project Committee's responsibility to implement the project and report the status of the project to the sponsoring cub.

Chair

Name: ______

Postal Address:______

Home Tel:______

Business Tel:______

Email: ______

Committee Members

Name: ______Name:______

Postal Address:______Postal Address:______

Home Tel:______Home Tel:______

Business Tel:______Business Tel:______

Email:______Email:______

4. OTHER PARTICIPATING ORGANIZATION

Complete this section onlyif the project involves another, non-Rotary organization.

Name of Organization:______

Attach a letter from that organization confirming their need and or support for this project.

5. SPONSORING ROTARY CLUB PROJECT COMMITTEE

AProject Implementation Committee of at least three Rotarians must be established for the project. It is the Project Committee's responsibility to coordinate the project, monitor funds and provide reporting and financial accounting to the District Community Grants Committee. The chair of this Project Committee (as listed above, see paragraph 1) will be responsible for successful project completion and compliance with District InternationalGrant reporting requirements. The other committee members:

Name: ______Name:______

Postal Address:______Postal Address:______

Home Tel:______Home Tel:______

Business Tel:______Business Tel:______

Email:______Email:______

6. TERMS AND CONDITIONS FOR THE DISTRICT INTERNATIONAL GRANT

1. Program Requirements

●Use of all grant funds must comply with these Terms and Conditions

●Grants must respect the wishes of the receiving community and strive to understand and appreciate its traditions and culture.

●Grants require the direct involvement of Rotarians to:

  1. Access community needs and develop a project plan;
  2. Establish a committee of at least three Rotarians to oversee the expenditure of funds;
  3. Oversee grant funds;
  4. Implement project(s);
  5. Provide evidence of community involvement and ownership;
  6. Organize meetings with local service providers, local officials and/or recipients;
  7. Promote the project in the media.

2. Policies

●Projects must be initiated by the Rotary Club making the application

●Grant funds cannot be used for:

  1. salaries, stipends, or honorariums;
  2. operating expenses of another organization;
  3. personal or professional development.

3. Guidelines

  1. The District Grants Committee will accept applications from Jan through May of each Rotary year for the following year. Grant award reimbursement will be provided upon the submission of complete and final project report. If this guideline presents a hardship for an application, please note in the application and the Grants Committee will consider other arrangements.
  2. Incomplete applications will be returned to the Club.
  3. The Grants Committee will review a Club's application only if that Club's District 7170 and Rotary International dues are current.
  4. The Grants Committee will award the Grants based on project merit, amount of request, amount of club’s contribution toward the project and the submitting Club's past contributions to The Rotary Foundation. Clubs that did not meet past grant reporting deadlines might not be considered.
  5. The Grants Committee will entertain any and all requests up to $5,000 USD, but may choose to approve an amount less than the requested amount. However, it will not be for an amount less than $1,000.00 USD

4. Reporting Requirements

The sponsoring Rotary Club must submit a final report in order to obtain the grant payment reimbursement. The final report must include:

  1. A report (electronic)that provides detail of all expenses. For auditing purposes, please retain all original receipts and submit copies for reimbursement;
  2. Documentation of Rotarian participation in the implementation of the Grant, which reflects the required Rotarian activities and includes photographs(electronic, if possible)appropriate for publicizing the completed project;
  3. A narrative that includes information on the implementation of the project(s) and how experience gained from it will inform/guide the District for the next Rotary year.

7. APPLICATION FORM COMPLETION CHECKLIST

Please complete all sections of the form and note that incomplete applications will not be considered. Grant awards will be between $1,000 USD and no more than $5,000 USD.

Before submitting this application, please take a minute to review this checklist and make sure that your application is complete.

Have you:

Completed all of the sections of the application form?

 Attached a Description of Project Proposalas requested in Section 2?

Attached, if appropriate, a letter of support from any other affiliated organization as requested in section 3?

 Obtained the signature of the sponsoring Rotary Club President on this application?

Please answer the following questions:

Are your District 7170 and Rotary International dues paid current? ______

Is your club up-to-date with reports on other Rotary grant projects? ______

8. ROTARY CLUB COMMITMENT

The following signature of the sponsoring Rotary Club President for the period during which the project will be undertaken, confirms that:

  1. All information contained in this application is true and accurate, to the best of our knowledge; this application meets the criteria that is set out above for Terms and Conditions for the District International Grant;
  2. The Club has agreed to undertake this project as an activity of the Club and organization (if any) involved;
  3. We understand and will comply with the required Rotarian activities and reporting requirements as stated;
  4. We agree that and reports will be provided within one month after project completion and no later than 30 May of the grant year, whether the project is completed or not.

Sponsoring Rotary Club (District 7170)

For the Rotary Club of ______Date: ______

(Print Name)(Please Print)

Club President:______Signature:______

(Print Name)(Signature)

Host Rotary Club (International)

For the Rotary Club of ______Date: ______

(Print Name)(Please Print)

Club President:______Signature:______

(Print Name)(Signature)

If you have any questions or concerns, please contact the Chair of the District Grants-Committee as listed below. Further information regarding project eligibility is also available at the Rotary International website at

RI publishes comprehensive Terms and Conditions for all Grants, available for download at:

Please send the completed application form and all attachments by June 1, 2015by email to:

Robert O. Ross, PDG,

District 7170 Foundation Grants Chair

126 Willowbrook Drive

Auburn, NY 13021

(315) 255-3020

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