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ROTARY CLUB OF ASPEN

COMMUNITY GRANTS

2017 GRANT APPLICATION FORM

Please complete the information requested below. If you wish to add comments, please do so on a separate sheet of paper but limit yourself to only one additional page. Return your completed form to John Moore, Chair of the Aspen Rotary Club’s Community Grants Committee at jcmoore3@msn.com. The deadline for submissions is Feb. 28, 2017.

1. ORGANIZATION INFORMATION:

i.     Name of organization:

ii.    Mailing Address:

iii.   Contact person:

iv.   Phone Nunmber:

v.    Fax Nunber:

vi.   Email of contact person:                                                                    

vii.  501©(3) No. (very important) if not an education institution.

2. BRIEFLY STATE THE MISSION OF YOUR ORGANIZATION:

3. WHOM DO YOU SERVE AND HOW MANY PEOPLE DO YOU SERVE?:

4. AMOUNT OF FUNDS REQUESTED:

5. HOW DO YOU PLAN TO USE THESE FUNDS (BE SPECIFIC)?:

6. PLEASE PROVIDE A SUMMARY OF KEY INCOME AND EXPENDITURES FOR THIS FISCAL YEAR INCLUDING STAFF PAYROLL AND ADMINISTRATIVE OVERHEAD:

7. OTHER COMMENTS: