2019-2020 District Grant Application Submission Deadline August 30th 2019
Preparing and submitting a District Grant (DG) report

Step 1: Apply for District Grant by Deadline July 1st 2019 by Completing each section of the attached form. Once approved you must submit all reports and documentation as described below within two weeks of project completion.

Step 2: If necessary, follow up with project contacts to complete missing report information or to address eligibility issues. The District Grant Chair or the District Foundation Chair. DistrictGrants@Rotary7255.org

Step 3: Email scanned report, including receipts, with accompanying bank statement(s) to The District Grant Chair or the District Foundation Chair. DistrictGrants@Rotary7255.org OR Use the form on www.Rotary7255.org

Please note the following:

CLUBS WHO DO NOT SUPPORT THE ROTARY FOUNDATION WILL NOT BE ELIGIBLE FOR FUNDS

CLUBS WHO HAVE NOT PAID THEIR DISTRICT DUES WILL NOT BE ELIGIBLE FOR FUNDS

• Reports must be submitted using the form below. Please type the report. Retain a copy of the entire report for your records.

• Clubs should retain original receipts for all grant-funded expenditures and provide copies to the district. The district must maintain copies of all receipts related to grant-funded expenditures in accordance with local laws and for a period of at least five years following closure of the grant.

• Bank statements showing grant deposit and all expenditures related to the grant must be maintained by the club and a copy scanned and emailed as instructed above.

• The approved amount of the grant will be determined by our District Grants Subcommittee and may be less than the amount you request but it will not be greater than the amount you request.

• Approved District Grants must include the active participation of Rotarians

• District Grants will not be awarded to clubs for High School or College scholarships, Vocational Training Teams, or District programs with a budget line item (i.e. Youth Exchange, RYLA, etc.)

• Expenses cannot be incurred until after approval in order to qualify (all receipts must be dated AFTER grant approval date)

Email address *
Club Name *
Please DO NOT put Rotary or Rotary Club of JUST PUT THE TOWN/NAME of the club
Your answer
EIN # *
This is your club Tax ID # (Employer Identification #) it does NOT come from Rotary, ask your club Treasurer to provide it to you.
Your answer
Club Mailing Address *
This is the address where the grant check will eventually be mailed if we can't find you at a district meeting
Your answer
Contact Name *
Your answer
Contact Title (Club President, Club Foundation Chair, etc.)
Your answer
Contact Phone Number *
Your answer
Which District Grant conference call did you attend? *
Project Type *
Project Title *
Your answer
Amount Requested (USD) *
Your answer
Has your club done this project before? *
Project Description *
What will be done, when, and where will project activities take place?
Your answer
Project Reach *
How Many people will benefit from this project (estimated)
Your answer
Rotarian Involvement *
How Many Rotarians will participate in this project?
Your answer
Rotarian Involvement *
Please describe the involvement of Rotarians (provide a minimum of two examples, NOT including financial support)
Your answer
Cooperating Organization(s) *
Did you partner with any non-Rotary groups on the project? If so what was their role?
Your answer
Reporting Documentation *
I have e-mailed the full project budget to DistrictGrants@Rotary7255.org with the name of my club and the words District Grant Report in the subject line prior to the grant application deadline.
Required
Reporting Documentation *
I understand that the final project report and copies of all invoices for expenses paid must be submitted to DistrictGrants@Rotary7255.org with the name of my club and the words District Grant Final Report in the subject line on or BEFORE June 30th 2020 in order to receive any grant funding.
Required
Compliance *
I understand that failure to provide any of the requested documentation may result in the rejection of my grant application and/or future grant applications by my club in the future.
Required
Certification *
By entering my name below, I confirm that to the best of my knowledge these District Grant funds were spent only for eligible items in accordance with Trustee-approved guidelines, and that all of the information contained herein is true and accurate. I also understand that all photographs submitted in connection with this report will become the property of RI and will not be returned. I warrant that I own all rights in the photographs, including copyright, and hereby grant RI and TRF a royalty free irrevocable license to use the photographs now or at any time in the future, throughout the world in any manner it so chooses and in any medium now known or later developed. This includes the right to modify the photograph(s) as necessary in RI’s sole discretion. This also includes, without limitation, use on or in the web sites, magazines, brochures, pamphlets, exhibitions and any other promotional materials of RI and TRF
Your answer
A copy of your responses will be emailed to the address you provided.
Submit
Never submit passwords through Google Forms.
reCAPTCHA
This form was created inside of Pittjcs. Report Abuse - Terms of Service