Rotary Club of St. Albert - Reaching Out: Grant Application
Please E-MAIL any additional information that you feel is important to your application.
For grants approved, a follow-up report may be requested.

Parents or guardians must be aware that a school is making this request on behalf of students

Contact information: Chair: Wayne McCutcheon wsm@shaw.ca

Child's Name *
Your answer
Address *
Include city and postal code (e.g. 10 Sesame Street, St. Albert, AB T8N 1A3)
Your answer
Phone number *
Use format 780-123-4567
Your answer
School *
Your answer
Grade *
Date of Birth *
MM
/
DD
/
YYYY
Recommended Lesson / Activity *
Please describe
Your answer
How this student meets the criteria: *
Your answer
How will this student get to the lesson / activity? *
Your answer
Cost / Fee: *
Up to $200 per child
Your answer
To register student we send cheque to: *
Address
Your answer
Your Name
Your answer
Your Email address *
Email address of the person filling out this form
Your answer
Your phone number (at school) *
Your answer
Are the student's parent(s) or legal guardian(s) are aware and approve of this application for funding *
Submit
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