Rotary District 5150 District Grant Application 2022-2023

Thank you for the good work your Club is about to do! Applications for DDF (District Designated Funds) are completed on-line and must be received by June 1, 2022. If you have questions about this application, please contact District Grants Coordinator Joe Teresi at districtgrants5150@gmail.com or 650-455-4887. Thank you for applying!

LEAD CLUB NAME * If Multi-Club Project, List Names of Supporting Clubs PROJECT TITLE * Briefly describe the project and what the project will do. * Start Date *

Estimated Completion Date *

District Grants require active involvement of Rotarians to:

• Assess community needs
• Develop a project plan
• Establish a committee of 2+ Rotarians to oversee expenditure of funds and implementation of the project
• Promote the project in local media
• Submit required reports on time

Number of Rotarians that will participate in this project? * Describe active participation by Rotarians (non-financial). Provide at least two (2) examples of active participation. * Number of non-Rotarians that will benefit from this project? * Who is the relevant community and how will the project improve their lives? * What are the expected long-term community impacts? *

Is this a Dictionary Project? *

Yes No

If so, how many dictionaries will be distributed?

Is this a RYLA Project? *

Yes No

If yes, how many students will be sponsored?

Will the project address any of Rotary International's 7 Areas of Focus? If Yes, which Area(s)? * *

No Promoting Peace Fighting Disease Providing Clean Water, Sanitation, and Hygiene Saving Mothers and Children Supporting Education Growing Local Economies Protecting the Environment

How will the project meet the goals of that Area(s) of Focus? * Describe how the general public will know that this is a Rotary-sponsored project. Provide examples. *

Is a cooperating organization involved? *

Yes No

If yes, what is the name of the organization(s) and what role does it play in the project?

BUDGET

The itemized Budget must specify:
INCOME

• District Grant funds/DDF
• Club funds
• Other funds

EXPENDITURES

• Costs of equipment
• Furniture items
• Gasoline
• Meals
• Lodging
• Training
• Number of dictionaries
• Etc.

Supporting documentation may be requested.
Receipts are required for the Final Report.

Income

District Grant Funds (DDF) requested up to $______ of available DDF. * Club Funds Other funds - please specify source Total Project Income *

Expenditures

Expected Expenditures - provide specific costs * Total Project Expenditures *

If your Club does not receive the entire amount of DDF requested, can your Club fund the shortfall from its own funds? *

Yes No

If No, can the project be downsized to meet the amount of the District Grant and Club contributions to the project?

Yes No

Club Primary Contact Name * Club Primary Contact Rotary Position * Club Primary Contact Email Address * Club Primary Contact Phone Number * Club Secondary Contact Name * Club Secondary Contact Rotary Position * Club Secondary Contact Email Address * Club Secondary Contact Phone Number *

Required Authorization

As President of this Rotary Club for 2022-2023, I affirm that the Club/Board has voted to undertake this project as an activity of the Club.

2022-2023 President's Name * Signature *

Date: Thursday, 25 April 2024 (EDT)

Name:

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2023-2024 President's Name (2022-2023 President-Elect) * Signature *

Date: Thursday, 25 April 2024 (EDT)

Name:

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Alternative Name (if 2022-2023 President-Elect is unknown)

Alternative's Rotary Position

International Service Chair Community Service Chair Club TRF Chair

Signature

Date: Thursday, 25 April 2024 (EDT)

Name:

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