P.O.

Box 532
Collingwood, ON
L9Y 4B2

The Rotary Club of Collingwood

Funding Application
Rotary Fiscal Year runs from July 1st to June 30th.
Please indicate if you are applying for funding for the current or next fiscal year:
Current Fiscal Year
Next Fiscal Year

Before Submitting Your Application,
Please Ensure the Following:
• All questions are completed
• All required materials are included

**INCOMPLETE APPLICATIONS CAN NOT BE PROCESSED**

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APPLICATION FORM
Organization's Name:
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Address: ___________________________________________________________________
Telephone: __________________________________________________________________
Fax Number: ________________________________________________________________
E-Mail: ____________________________________________________________________
Date Established: _____________________________________________________________
dd-mmm-yyyy

Name of Board Chairperson: ______________________________________________________
Name of Executive Director: ______________________________________________________
Telephone/Fax /Email (if different from above): __________________________________________

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Amount of Request: $_______________________________

Has your organization received funds from the Rotary Club of Collingwood in the past?

Yes

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Year(s)____________ Amount(s): $___________________

No
Please provide a brief description of the project/activity and outline its purpose and primary objectives.

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Rotary Club of Collingwood
Application for Funding

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Please describe the target group to whom the project/activity/program is directed:

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What is the geographic area served by this project/activity/program?

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How many people will be served by this project/activity/program? (i.e. number of users) ______________
How many of those served live in the Collingwood area? ___________________________________
What is the duration of the project/activity/program?______________________________________
How do you intend to measure project/activity/program outcomes? (i.e. the benefit, impacts/effects for the
community?)

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In what ways is Rotary recognized/publicized in this project?
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What other individuals or organizations financially support this proposal or related proposals and to what
extent?

None
or

If any other supporters, provide details below:

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Rotary Club of Collingwood
Application for Funding

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BUDGET:
Outline the budget requirements of your proposal. (if space is insufficient, please attach additional
documentation.)

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NOTES:
A. Upon receipt of the completed application, The Rotary Club of Collingwood may make independent
inquiries as to the merits of the proposal, and particularly as to whether or not it falls within the guidelines*
established by the Rotary Club of Collingwood.
B. If funding is provided, The Rotary Club of Collingwood reserves the right to satisfy itself that the money is
spent in accordance with the approved application and may require an accounting to this effect.
*Guidelines of the “Local/Community Donations Committee” are:
(i) Local projects only
(ii) No individuals
(iii) Some favours granted to requests in which Rotarians are involved
(iv) How effective and compelling is the promotional/public relations exposure for Rotary?
(v) Approval of funding does not imply that project has been accepted for on-going annual approval.

Signature of Person completing Application ____________________________________________
if submitting electronically, type name

Position in the Organization ______________________________________________________
Date of Application ____________________________________________________________
dd-mmm-yyyy

Completed Application can be:
(i) Emailed To Funding Co-ordinator (click "Submit Form" buttonEHORZ)
(ii) Mailed to: The Rotary Club of Collingwood
P.O. Box 532
Collingwood, ON
L9Y 4B2
Rotary Club of Collingwood
Application for Funding

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