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Longwood Rotary Foundation Grant Application
SPRING 2025
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* Indicates required question
Email
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Your email
Name of Organization or Agency
*
Your answer
Address
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Your answer
City
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Your answer
State
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Your answer
Zip
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Your answer
Phone
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Your answer
Fax
Your answer
Email
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Your answer
Executive Director or Primary Contact Person - Full Name
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Your answer
Executive Director/Primary Contact - Title
*
Your answer
Executive Director/Primary Contact - Phone Number (if different from above)
Your answer
Is the Organization Incorporated?
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Yes
No
Incorporation Name (if different from above)
Your answer
Is the Organization "Not For Profit" as defined by the IRS Chapter 501c?
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Yes
No
If 'Yes' Tax Exempt Number
Your answer
Is the Organization registered with the PA Dept of State, Bureau of Charitable Contributions?
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Yes
No
What is the "Mission" of your Organization?
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Your answer
What are your specific intended uses of the funds requested?
You MUST detail a specific program or initiative these funds will go towards; RCLF does NOT fund general operating expenses or ongoing organizational funding. Failure to specifically list uses for the grant will result in the grant request being denied.
*
Your answer
Please Describe your Organization - Be specific about WHO and how many people will be served by your organization, HOW those persons will be served, and WHAT BENEFITS they will receive as a result of your efforts and/or funding.
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Your answer
Amount of Funding Desired
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Your answer
What specific time of year (if any) do you need these funds and why
*
Your answer
Other Funding Sources: (email Financial Statement for last year to
foundation@longwoodrotary.com
)
Your answer
What are your other sources of monetary funding? (Please be as specific as possible)
*
Your answer
Active Organization Participants . Please include a listing of your Board of Directors
*
Your answer
Persons from any Rotary Club Who Are Active In Your Organization
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Yes
No
Volunteer Opportunities. What opportunities exist in your organization that would allow individuals or groups of Rotarians to support your programs through personal involvement in service delivery?
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Your answer
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By checking this box I acknowledge that I am required to submit a Final Report as soon as possible following receipt of any grant, and in no case later than June 30 of the current Foundation year. I understand that failure to file a final report will adversely affect any future grant requests.
Required
By clicking submit, I, represent to Longwood Rotary Foundation that the information provided in this application is true and correct as of the date indicated.
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