BRAINERD ROTARY FOUNDATION
P O BOX 132
BRAINERD MN 56401

 THE MISSION OF THE BRAINERD ROTARY FOUNDATION IS TO ASSIST IN PROVIDING FINANCIAL SUPPORT FOR ACTIVITIES DESIGNED TO OFFER PERSONAL AND EDUCATIONAL OPPORTUNITIES FOR AREA YOUTH.   Applications for funding will be reviewed in January, April, July, & October.

 GRANT APPLICATION

1.                  Name of Organization/Individual:_____________________________________________

2.                  Address:_______________________________________________________________
                                Street                                                City                        State                    Zip

3.                  If  an Organization, name of contact person:_____________________________________

4.                  Phone:______________________  e-mail:_____________________________________

5.                  Is Organization ______ For Profit     ______Non-Profit     ______501(c)3 if non-profit?

6.                  Organization History/Purpose:_______________________________________________

______________________________________________________________________

______________________________________________________________________

______________________________________________________________________

7.                  Geographic area served:___________________________________________________

Please state number of youth served within Independent School District 181__________

GRANT REQUEST          From Rotary Foundation            Towards Total Project Cost

8.                  Amount Needed                    $_________________            $_________________

9.                  Describe the project/request:________________________________________________

______________________________________________________________________

______________________________________________________________________

______________________________________________________________________

______________________________________________________________________

10.              How does your project meet the Rotary Foundation's Mission?    

______________________________________________________________________

______________________________________________________________________

______________________________________________________________________

11.              Please list other funding sources and their contributions to your Project:

            _____________________________________________________________________

_____________________________________________________________________

_____________________________________________________________________
 

12.              When is funding needed?__________________________________________________

The information contained in this application is for the purpose of obtaining funding from the Brainerd Rotary Foundation on behalf of the undersigned.  The information provided is true and correct.

 
________________________________________________               Date:_____________________

Signature                                                  Title