GRANT REQUEST INFORMATION

DEADLINE FOR APPLICATIONS: FEBRUARY 28, 2021

 

    Date of Application*
    Project Date*

    Charitable Registration #*

    Formal Name of Organization*

    Mailing Address*

    Email Address*

    Phone Number*

    Fax Number

    Describe Project for which you are requesting funds*

    Cheque to be made payable to (if request granted)

    Name of Contact Person & Position

    Phone/Fax/Email (if different from above)

    Email Address:

    Phone Number:

    Fax Number:

    Total of Request:

    Describe how the funds will be used:

    Who will be served by this request:

    Are you Funded by any other sources? Is so, please provide detailed list:

    Have you requested funds from our club before?:

    If yes, when??(Attach report of how money was used along with recognition that was provided for our support) :

    How do you recognize donors?: