District Grant 2016-17 Individual Project Summary Report
This form is to be used to submit a District Grant Progress or Final Report.
Club and Project Name/Report Type
Club Name and Number *
Project Title *
Your answer
Report Type: *
Your email address? *
Your answer
Community Impact
Provide detailed information regarding the project and its beneficiaries. How were they helped? *
Your answer
How many non-Rotarians benefited from this project? *
Your answer
How has this project provided community members with specific skills or knowledge that will allow them to help themselves? *
Your answer
If a cooperating organization was involved, what was its role? If non, please respond NONE. *
Your answer
Rotarian Involvement
How many Rotarians participated in the project? *
Your answer
How did they participate? *
Your answer
Provide an overview of the project spending (retain receipts of all expenditures): *
Include item names and cost per item
Your answer
Certification
By signing this report, I confirm that the District Grant Funds stated below were spent in accordance with the Trustee approved guidelines and that all of the information contained herein is true and accurate. You will retain all receipts for expenditures for a minimum of five years in case of audit.
Total District Grant Funds expended? *
Your answer
By checking this box you, the Club District Grant Chair, agrees to all conditions set forth in the dialogue above *
Required
Club District Grant Chair e-signature *
Your answer
Reports
1. A final report is required by April 30th 2017 or upon the completion of the project.
2. The report is to be made on the District Grant / Final Report Form, found on the District Website www.rotarydistrict7500.org
Submission Instructions
A copy of this application will be e-mailed to you as well as the District Grant Committee Chair.

Once you submit your application - you can make correcrtions. After hitting SUBMIT you will be brought to a Thank You page, you can click on EDIT YOUR RESPONSE, to make any changes. You must hit SUBMIT again to change your responses.

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