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Westborough Rotary Club Request for Service
Please complete this form with your service request. After we have reviewed your request, a Rotary member will contact you to discuss your request.
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Email
*
Your email
Full name
*
Your answer
Phone number
*
Your answer
Name/Description of project/activity
*
Your answer
New or Existing project/activity
*
New
Existing
Required
Start date and time of project/activity
*
MM
/
DD
/
YYYY
Time
:
AM
PM
End date and time of project/activity
*
If your activity/project is just one day, please enter the same date as above and choose the end time.
MM
/
DD
/
YYYY
Time
:
AM
PM
What area of focus does this project/activity fall under. Check all that apply:
*
Environment
Education & Literacy
Maternal/Child Health
Peace & Conflict Prevention/Resolution
Disease Prevention
Economic & Community Development
Water & Sanitation
Other:
Required
If "other," please describe here.
Your answer
What is the goal of this project/activity?
*
Your answer
How many people will benefit?
*
Your answer
How many volunteers will be needed?
*
Your answer
How will volunteers be utilized?
*
Your answer
Is this project/activity request seeking Rotary funding?
*
Yes
No
Maybe
If "yes" or "maybe" to funding, what amount?
Your answer
Please submit any additional notes that would like us to know about your request. Thank you!
Your answer
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