Rotary Club of Lantzville
Community Application for financial support from the Rotary Club of Lantzville
Name of Organization *
Address *
Telephone *
Contact Person and position *
E-mail *
Briefly describe your organization *
Are you currently governed by a Board of Directors
Do you Currently receive "gaming Funds" from B.C. Government *
How many paid staff do you currently employ? *
How may volunteers are affiliated with your organization? *
Have you received funds from the Rotary Club of Lantzville in previous years? *
If yes, please provide a brief description of the project supported by the Rotary Club of Lantzville
Please indicate which area of need in the community your proposal addresses *
Would the result of our support produce an immediate impact on the recipients? *
Will the outcome of the project be achieved within 3 months
Briefly outline the proposed project; describing the long and short term objectives of the project and who it will benefit.
Please indicate the amount of money being requested *
Have you requested funds for this project from other sources? *
If yes,
Clear selection
List other sources of revenue for the proposed project *
Will Lantzville Rotary members be able to participate in any hands on elements of this project. *
If yes, please explain:
If required, would you be able to provide your most recent financial statement? *
If no, please indicate reason
Is there anything else we should know while reviewing this application?
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