Rotary Club of Lantzville
Community Application for financial support from the Rotary Club of Lantzville
Name of Organization *
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Address *
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Telephone *
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Contact Person and position *
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E-mail *
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Briefly describe your organization *
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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? *
Your answer
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
Your answer
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.
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Please indicate the amount of money being requested *
Your answer
Have you requested funds for this project from other sources? *
If yes,
List other sources of revenue for the proposed project *
Your answer
Will Lantzville Rotary members be able to participate in any hands on elements of this project. *
If yes, please explain:
Your answer
If required, would you be able to provide your most recent financial statement? *
If no, please indicate reason
Your answer
Is there anything else we should know while reviewing this application?
Your answer
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