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Learning Fund Application Form
Thank you for your commitment to learning and your interest in our Learning Fund support. Please complete the application form below and one of our team members will be in touch soon! For questions reach out to Kendra Luta at
kluta@rotarycharities.org
.
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* Indicates required question
Email
*
Your email
Eligibility: Applicants for Learning Fund support must be affiliated with a 501(c)(3) tax-exempt organization, local unit of government or Native nation. Which of the following do you represent?
*
501(c) 3 nonprofit organization
Local unit of government
Native nation
Other:
Eligibility: Applicants for Learning Fund support must serve Antrim, Benzie, Grand Traverse, Kalkaska or Leelanau Counties. Check all that apply.
*
Antrim
Benzie
Grand Traverse
Kalkaska
Leelanau
Required
Name
*
Your answer
Title
*
Your answer
Organization
*
Your answer
Street Address
*
Your answer
City, State, Zip Code
*
Your answer
Phone Number
*
Your answer
Link to your organization's website
*
Your answer
Federal Employee ID Number
*
Your answer
Is this your first application to the Learning Fund?
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Yes
No
Is this request for an individual (up to $500) or a team (up to $2,000)?
*
Individual
Team (4 or more)
If this is a team request, include the names, email addresses and organizations of the team members that will be joining you.
Your answer
Total cost of learning experience
*
Your answer
Amount of funding request from our Learning Fund
*
Your answer
Describe the learning experience you wish to attend, including a link to any relevant promotional information.
*
Your answer
What is the format of this learning experience?
Virtual learning
Face-to-face learning
Hybrid
Other:
Clear selection
Check the following option that best describes this learning experience.
1-2 hour learning session
1/2 day workshop/conference
Multi-day workshop/conference
Cohort program
Other:
Clear selection
Describe how this learning experience will help increase your capacity to meet your mission or increase your impact in community. Include specific learning outcomes and how you plan to apply these learnings.
*
Your answer
Start date of learning experience
*
MM
/
DD
/
YYYY
End date of learning experience
*
MM
/
DD
/
YYYY
Select one of more of our guiding principles that you think are most closely related to your learning experience. (Check all that apply)
Inclusive
Collaborative
Resourceful
Reflective
Adaptive
Aligned
Describe how your learning experience is related to the mission, vision and guiding principles of Rotary Charities.
Your answer
Describe the financial need that has led you to apply for Learning Fund support.
Your answer
Feel free to provide any other information below.
Your answer
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