Please complete all sections of this application. Attach additional pages as needed or answer the questions below on blank paper, providing the answers in the same order as the application. Incomplete applications will be returned.
SPONSORING MEMBER/NAME OF ORGANIZER ____________________________________________________
PHONE NUMBER _______________________________________ DATE _______________________________
E-MAIL ADDRESS ____________________________________________________
1. PROJECT NAME AND DESCRIPTION
Note: The project cannot be started until this application is approved by the Clackamas Rotary Foundation Board.
D. Location and date of event:
E. Who are you going to promote this event to? How are you going to promote? Estimated number of participants?
F. What is/are the benefit(s) of this fund raising idea? Why would individuals want to contribute/donate to this event?
G. What else should we know?
2. COOPERATING ORGANIZATION
Is another organization directly involved in the implementation of the project? If so, provide a letter from the organization indicating how they will work with Rotarians in the implementation of the project and agree to cooperate in any financial review of activities associated with the project.
3. PROJECT BUDGET
Items to be Purchased Cost
A. ____________________________________________________________________________________
B. ____________________________________________________________________________________
C. ____________________________________________________________________________________
D. ____________________________________________________________________________________
E. ____________________________________________________________________________________
Project Budget Total: _______________________________
4. PROPOSED FINANCING List all Financing i.e. donations/grants (attach requests)
5. APPROXIMATE AMOUNT TO BE RAISED: ______________________
6. PROJECT TIMELINE:
Estimated Start Date of Project _______________ Completion Date of Project _________________
Project Committee: A committee of at least two Rotarians must be established in the sponsoring club. It is the committee’s responsibility to coordinate the project locally, monitor funds, and provide financial accounting to the Clackamas Rotary Foundation Board for the duration of the project.
Name |
|
|
Telephone |
Preferred Number |
|
Rotary Position/Title |
|
|
|
Secondary Number |
|
|
|
|
|
|
|
Mailing Address |
|
|
Fax |
Preferred Number |
|
Additional Contact
Name |
|
|
Telephone |
Preferred Number |
|
Rotary Position/Title |
|
|
|
Secondary Number |
|
|
|
|
|
|
|
Mailing Address |
|
|
Fax |
Preferred Number |
|
|
|
|
|
|
|
NOTE: Please retain a copy of this application for your files, and send a copy to____________________________________. The Application may be submitted electronically.
7. AGREEMENT FORM
This Application and Agreement are entered into between the identified project sponsor below and Clackamas Rotary Foundation Board. The project sponsor agrees to:
All applicable laws of the State of Oregon, USA, govern this Agreement.
By signing on the signature page attached, I certify that the sponsors acknowledge and accept the terms of this Agreement and agree to abide by the stipulations set forth.
Clackamas Rotary Club Foundation
Club President _____________________________________________
Date__________________________________
- - - - - - - - - - - - - - - - - - - - DO NOT WRITE BELOW THIS LINE - - - - - - - - - - - - - - - - - - - - - -
Clackamas Rotary Club Foundation Board
____ approves the request ____ amend the request and resubmit ____denies the request
Reviewed by ___________________________________ Date ____________________
Approved by ____________________________________ Date ____________________