Application for Funding

Rotary Club of Glens Falls, New York

 

Application for Funding ($500 or more)

 

1.   Date __________________   

 

2.   Requesting Organization: ___________________________ 

3.   Address: _________________________________________

      (Please provide the complete name and mailing address of your organization.
        If funding is approved, this is where the check will be mailed.)

 

4.    Person Making Request: __________________________
       Phone #: ________________________

 

5.    Name of Project: ___________________________________________

 

6.   Has this project been funded before by Glens Falls Rotary?
       YES    NO    (circle one)

 

7. Please briefly describe the project, how Rotary funds would be used,
and other sources of funding:

_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________

 

8.   Please describe how the project fits into one of the Avenues of Rotary
Service (Club service (strengthening fellowship and functioning of the
Club), Vocational service (serving others through our vocations while
practicing high ethics), Community service (projects and activities to
improve life in the community), and International service (to expand
Rotary's humanitarian reach to promote world understanding and
peace): ________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________

 

9.   How could Glens Falls Rotarians personally assist in the implementation of the project? ________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________

 

10.    Will this become an annual funding request?  YES  NO (circle one)

 

 11.   If funding is provided by Glens Falls Rotary, how will the Club and Rotary be acknowledged publicly for their contribution (signage, etc.)? ________________________________________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________

 

12.   Amount Requested: __________________
        Date Required: _____________________

Please mail this application to Rotary Club of Glens Falls, PO Box 4702, Queensbury, NY 12804  

 

Meeting Time & Location Information Thursday at 12:15 PM Queensbury Hotel 88 Ridge Street Glens Falls, NY 12801  map it USA	Contact Information Dr. Shelle Kelz phone: 518-743-0773 fax: 518 743-0774 contact us www.glensfallsrotary.com