Please fill up and submit the form below to become a candidate of our grant recipient.

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Name of Applicant/Organization: *

List of charities and certain other qualified donees – basic search – CRA

Registration no.(CRA) *

Address:

Postal Code:

Phone:

Name of Person Submitting Application:

Position/Title:

Contact Info:

Email:

Website:

Single Line Text

Brief description of organization, activities, membership etc. You may attach brochure/PR material.

Total amount required for project: $

Amount requested in this application: $

Purpose for which financial assistance is requested. Be specific about community impact:

Describe who would benefit from this assistance:

Describe how this financial assistance request support any of the two purposes of the Rotary Richmond Foundation: (a)To support charitable activities and projects which contribute to the improvement of health, thedevelopmentofeducation,andthe alleviation of poverty, and (b)To support charitable activities and projects which respond to emergencies, urgent needs and unique concerns in the community.

How would your organization recognize our support?

Project Start Date:

Project Completion Date:

Deadline for funding:

CRA Registration Number: *

Current Charity Status:

Please include the following information with your application:

• Attach a list of names of the Board of Directors including phone numbers (if applicable)
• Attach last fiscal year’s financial statements (if applicable).
• Attach budget for this project.
• Attach PR materials/brochure etc.

Signature (Please type your name)

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