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
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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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