GRANT APPLICATION FOR FINANCIAL SUPPORT FROM THE ROTARY CLUB OF VICTORIA, B.C. INTRODUCTION The Rotary Club movement was founded by Paul Harris, a Chicago Illinois, USA businessman on February 23, 1905. The club was called Rotary because Members met in rotation at their various places of business. The Rotary Club of Victoria was formed on January 1, 1914, and is one of the oldest in Canada. There are now (in 2006) over 32,000 Rotary Clubs in 200 countries around the world. The object of Rotary is to encourage and foster the ideal of service as a basis of worthy enterprise... and in fact, Rotary s motto is Service above self. The objective of one of Rotary International s major programs, Polio-Plus, is to protect all the children in the world from polio. The Rotary Club of Victoria, B.C. is proud of its record of years of service to the Greater Victoria community. It has contributed to the building of parks, play grounds, seniors/low cost housing, and has provided thousands of volunteer hours to community projects and hundreds of thousands of dollars to individuals and not-for profit agencies to help them ease the burden of their everyday activities. The Club disperses several thousands of dollars each year to worthy projects. Money is raised through an annual Car Raffle and other fund raising initiatives. Our Club also has a Foundation to which members and others contribute financially and this provides investment income. Application for financial assistance for community or individual projects must be directed to the Chair, the Community Needs Committee, the Rotary Club of Victoria, B.C. The committee reviews all applications and makes recommendations to the Club s Board of Directors. In order to treat all applicants as fairly and equally as possible, applicants are requested to submit a completed application form. Applications from not-for-profit organizations will, generally speaking, only be considered if the organization has a charitable registration number issued by Revenue Canada. The Rotary Club of Victoria, B.C. anticipates that recipients of grants will give the Club appropriate public recognition, such as in the media, in-house publications, and annual reports or appropriate identification on hard assets/equipment such as a plaque or name plate. Page 1
GRANT APPLICATION FOR FINANCIAL SUPPORT FROM THE ROTARY CLUB OF VICTORIA Chair, the Community Needs Committee Rotary Club of Victoria, BC c/o Union Club of BC, 805 Gordon St., Victoria. BC. V8W 1Z6 (Note: All applicants seeking support in excess of $400.00 must provide all of the information requested on this application. Generally speaking, no grants will be given more frequently to the same applicant than once every three (3) years). 1. Date of Application: 2. Legal Name of Organization or Person Applying: _ 3. Year Formed (if organization) Current Operating Budget 4. Name of other donors to whom an application has been made indicating those from whom funds have been received or promised. a) b) c) 5. Name of Executive Director 6. Contact person and title: 7. Address: 8. Mailing Address if different from above: 9. Telephone Number: Fax Number: 10. Revenue Canada Registration No. (If applicable) 11. Name of project being considered: 12. Purpose of Grant (one sentence) _ Page 2
13. Beginning and ending dates of project 14. Amount Requested: $ Total cost of Project: 15. Geographic area served 16. Name of Board of Directors Chair: Signature of above and Date: Date: 17. Signature of Executive Director: Date: 18. Signature of person completing application: 19. Date of last application to this Rotary Club: (If applicable) 20. Do you have a BC Gaming Commission licence? No Yes Licence number: 21. Please outline how you would provide ongoing recognition for the contribution of the Rotary Club of Victoria. Page 3
For the Rotary Club of Victoria, B.C. use only Date application received: Date submitted to Community Needs Committee: Committee member assigned to this account: Date given to above individual: Any instructions: Date application accepted/rejected: Date given to Board for approval: Date of approval by Board: Date funds disbursed: Page 4
NARRATIVE OF GRANT APPLICATION: - Please Note: It would be appreciated if you would structure your written proposal to provide the following information in the order indicated. Use the headings and sub headings as indicated and in your own words, as briefly as possible, answer the questions. Section for Organizations only: A) Organization information: summarize history state mission, goals and how your project fits in with your long-range plans outline current programs/activities and projects major accomplishments B) Purpose of Grant: briefly describe proposed project identify the needs/problems to be addressed, target population and approximate number of people that will be served by your project describe goals and objects of project and how you plan to meet them provide a timetable for project name of project facilitator C) Evaluation: indicate how you plan to record progress and results of your project how do you plan to evaluate the project (applicants who accept funds from the Rotary Club of Victoria, B.C. do so on the understanding that they will provide a copy of the project evaluation) name of person who will prepare and be responsible for the evaluation and the approximate date at which the evaluation will be deposited with the Rotary Club. D) Attachments: list of officers and directors copy of proposed project budget annual report of organization, if available letters or documents of support (optional) other information supporting your project To Be Completed Only By Applicants Who Are Individuals: For what purpose will the grant be used? Total cost? Describe briefly why you want to carry out your project or need the piece of equipment? If a Rotary grant will not cover the total cost of your project or piece of equipment, state briefly how you plan to finance the balance. If a piece of equipment is involved state briefly what will happen to the equipment if and when it is no longer needed by the applicant. Page 5