P&C APPLICATION

2020-2021 GRANT APPLICATION

The P&C GRANT APPLICATION is required for any consideration of funding. Verbal or other written requests can not be honored. The Rotary Club of Syracuse, Inc. can only accept requests from recognized 501c3 organizations or 501c3 sponsors. The form has limited space for some answers. If more space is needed to answer questions, we encourage applicants to attach additional files (PDF ONLY) to an email sent to: P&C APPLICATION.

NOTICE: USE EITHER MICROSOFT INTERNET EXPLORER OR GOOGLE CHROME WEB BROWSERS TO FILL AND SUBMIT YOUR APPLICATION.

Your Name: Last, First

Required

Email: abcd@efghijk.lmn

Required

Submitting Application...

Something went wrong. Please call Jim Morrow at 315.425.0051.

Application received. The P&C Committee chair will be in contact to discuss your application within 24 hours.

Title: Your title at your organization

Required

Your Phone Number: (123) 456-7890

Required

Requesting Organization: Name of 501(c)3 organization requesting funding

Required

Name of Project:

Required

Total Cost of Project: $

Requested Grant: $

Sponsor Organization: If different from organization requesting grant

Required

Address: 123 Main Street, Suite 1

Required

City, State, ZIP Anytown, ST, 12345-7890

Required

Organization EIN Enter your organization's Employer ID Number

Required

Description of Project: Enter a description of the project for which funds are requested.

Required

How many and what kinds of people do you expect will be served by this project?

How much of your funds, staff and resources will you commit to this project?

Specifically itemize in detail all significant items and costs associated with the proposed project for which funds are requested in this application:

Are you applying to other organizations for funding?

YES. We intend to request funds for this project from other sources.

NO. We do not intend to request funds for this project from other sources.

If you do intend to approach other organizations, which ones and in what amounts? When did/will you apply and when do you expect to hear from them?

If you plan on repeating this project, how will you fund this project in the future years?

Is this a one-time project?

YES, it is a one time project.

NO, this project will be repeated in the future.

Briefly describe your organization’s principal purpose and programs.

What is the professional background of the individual who will administer this grant:

Date of Determination Letter that your organization is currently exempt under the provisions of 501c3 of the Internal Revenue Code: Month, Day, Year

Who will administer this grant? Last, First, title, organization

When do you expect to begin this project? Month, Year

List of your senior staff, officers and governing board. Last, First, positionLast, First, positionLast, First, position

We further commit to abide by any conditions set by the Rotary Club of Syracuse, Inc. and the Syracuse Rotary Foundation, Inc. if a grant is accepted. First name, Last name of the Executive Director, CEO, or organization official

Will you be appending this application with other material?

YES. I will attach PDF files with additional information and/or supplements for this application to an email.

NO. The completed form above constitutes our entire application for funding from The Rotary Club of Syracuse, Inc.

I understand that checking this box constitutes a legal signature confirming that I acknowledge and agree to the above Terms of Acceptance.

TERMS OF ACCEPTANCE

This application must be submitted by a 501c3 exempt organization. If the Requesting Organization is not a qualified 501c3, then this application must be submitted by a qualified 501c3 Sponsoring Organization, which must sign a Certificate of Sponsoring Organization form.

NOTICE

After clicking submit below, you will be taken to a confirmation page. Check your email. Once your application form is received, the P&C Committee may request needed clarification. If sending additional or supplemental application material via email, please attach PDF files only and be sure your organization's identity is in the subject line. Submission of any other file format will not be accepted.

The undersigned Requesting Organization certifies that the representations in this request for a grant from the Rotary Club of Syracuse, Inc. and the Syracuse Rotary Foundation, Inc. are correct to the best of its knowledge, and that any funds granted by them will be used strictly in accordance with this proposal.

It is understood that a written report of the project and an accounting of the funds of the Rotary grant is required within six months of our receipt of funds or at the end of the project. If the project will not be completed within six months, we will give the Rotary Foundation a date by which it may expect that report.

PRESIDENT: JAMES YONAI | VICE PRESIDENT: PAUL SZEMKOW | SECRETARY: JOHN BERTRAM | TREASURER: GEORGE DE ANGELO | SERGEANT-AT-ARMS: JAMES MORROW