Rotary Foundation Grant Application

Please complete the application located below. If you have any questions please contact our foundation chair by completing the form at the bottom of the page.

Application Date*
MM slash DD slash YYYY
Section 1
Organization Name*
Organization Federal Tax ID*
Amount of the Standard grant your organization is requesting:*
Please describe your organization’s purpose, programs, location and geographic scope of operation, and number and types of clients served; please specify what percentage of your services are provided to residents of the City of Alexandria (Limit: 250 words):*
Section 2
Please explain how you would use this grant to help those impacted by the COVID-19 pandemic. Please describe how, when, and where the grant would be used – please be specific in detailing its program or project populations, activities and objectives. What percentage of this grant would directly benefit residents of the City of Alexandria? Would this grant provide full funding for a program or be used in combination with other funding? Has that other funding been secured? (Limit: 600 words)*
Please describe the special needs of those to be served with this grant and specify how those individuals will benefit from this grant (Limit 250 words):*
Please describe how your organization measures and evaluates the success of your programs (Limit 400 words):*
Would you still be able to accomplish your objectives with a lesser amount?*
If, no what is the minimum amount you would need to ensure that the project or initiative remains viable? (Limit 50 words)*
Section 3
Did anyone from your organization participate in the Rotary Club of Alexandria Central's Signature Fundraising Event?*
Which event did your organization participate in?*
What did your organization do for the event?*
Section 4
The following documents (indicate with a checkmark), which documents are being emailed to Club Foundation Grants Chair, Joan Renner, at joanrenner@rennercpa.com or mailed to the Rotary Club of Alexandria Central Foundation (mail to: 700 N. Fairfax St. Suite 400 Alexandria, VA 22314-2635 Attn: Rotary Club of Alexandria Foundation Chair):*
- Organization’s most recent IRS form 990
- Financial statement (internal or audited, if available)
- Most recent annual report (if available)
Please check to confirm the following information about your organization or provide a brief explanation as to why such information is not confirmed.*
- Operates pursuant to a written and up-to-date constitution and/or by-laws
- is in compliance with applicable federal, state, and municipal laws and regulations
- operates pursuant to policies designed to avoid conflicts of interest (written or informal policy)
- I would like to provide brief explanation as to why our information cannot be confirmed.
Why information above cannot be confirmed.*
Name*
First Last
Title*
Organization Name*
Email*
Phone*
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Rotary Foundation Grant Application

Section 1

Section 2

Section 3

Section 4