THE ROTARY CLUB OF SYRACUSE, INC.
The Rotary Club of
Syracuse has
been involved in community service activities throughout its history. Recently, Syracuse Rotary has provided over
one hundred thousand dollars in financial support for numerous
community
projects through the
At this time, we are
seeking
specific funding proposals from registered 501 (c) (3) community
organizations
based in
Our funding
guidelines provide
that funded projects usually involve applications for new programs,
capital
expenditures or startup projects.
Special consideration may be given to projects that will benefit
children, literacy or education. We will
typically not support projects that primarily benefit persons outside
of the
City of
If you have a specific project or need that you would like us to consider for funding, complete the enclosed application form. All questions must be answered completely or an explanation must be given for any question which is unanswered. You must break down the specific cost and specifications for each significant element of the project. In some cases we may consider funding an important part of a divisible proposal.
We expect to review
grant
requests before the end of November.
Grant applications should be submitted on or before
Rotary
Club of
Philanthropy and Charity Committee
c/o Jim Gladziszewski
Energy Automation, Inc.
5111
If you have any questions concerning this application, feel free to call the Co-Chairpersons of the Committee: Jim Gladziszewski: Telephone 315-487-9372 or Mark Corcoran: Telephone 315-476-6051
GRANT APPLICATION COVER SHEET
ROTARY CLUB OF SYRACUSE, INC.
PHILANTHROPY AND CHARITY COMMITTEE
Requesting Organization__________________________________________________
Address_______________________________________________________________
Individual to Contact____________________________Telephone________________
Sponsoring 501 (c) (3) Organization (if different from Requesting Organization)
____________________________________________________________________
Name of Project_______________________________________________________
Amount Requested_______________
Description of the project for which funds are requested (no more than twenty lines):
GRANT APPLICATION
How many and what kinds of people do you expect will be served by this project?
Total cost of the entire project__________________________________________
How much of your funds, staff and resources will you commit to this project?
Specifically itemize in detail all significant items and costs associated with the proposed project for which funds are requested in this application:
Do you intend to request funds for any part of this project from other sources? If so, which ones, and in what amounts? When do you expect to hear from them?
Is this a one-time project? If not, how will you fund this project in the future years?
When do you expect to begin and complete this project?
Briefly describe you organization’s principal purpose and programs.
Who will administer this grant? ________________________________________
Position and professional background of the individual who will administer this grant:
Attach a list of your officers and the names of your governing board.
EIN_____________________________
Have you received a determination Letter that your organization is currently exempt under the provisions of 501 (c) (3) of the Internal Revenue Code?______________
Date of Determination Letter:________________________
The undersigned Requesting Organization certifies that the representations in this request for a grant from The Rotary Club of Syracuse, Inc. and the Syracuse Rotary Foundation, Inc. are correct to the best of its knowledge, and that any funds granted by them will be used strictly in accordance with this proposal.
It is understood that a written report of the Project and an accounting of the funds of the Rotary grant is required within six months of our receipt of funds or at the end of the project. If the project will not be completed within six months, we will give the Rotary Foundation a date by which it may expect that report.
We further commit to abide by any conditions set by the Rotary Club of Syracuse, Inc. and the Rotary Foundation, Incorporated, if a grant is accepted.
Requesting Organization_________________________________________________
Requester’s Executive Director (typed)___________________________::__________
Signature of Requester’s Executive Director_________________________________
Date___________________________
NOTE: This application must be submitted by a 501 © (3) exempt organization. If the Requesting Organization is not a qualified 501 ( c ) ( 3), then this application must be submitted by a qualified 501 ( c ) (3) Sponsoring Organization, which must sign the following certificate:
Certificate of sponsoring
Organization
(If different from the Requesting Organization)
The undersigned Sponsoring Organization, by signing this Certification, agrees to receive, distribute and administer the use of the grant funds provided hereunder in strict accordance with all of the provisions and representations of this application, and of any conditions set by the Rotary Club of Syracuse, Inc., and the Syracuse Rotary Foundation, Incorporated. The Sponsoring Organization further agrees that it will be responsible for the use of all such funds by the Requesting Organization and the fulfillment of the Requesting Organization’s representations and obligations hereunder.
Sponsoring Organization________________________________________________
Sponsor’s Address______________________________________________________
Date of 501 ( c ) (3) Determination Letter____________________________________
EIN_____________________________
Sponsor’s Executive Director______________________________________________
Signature of Sponsor’s Executive Director____________________________________
Date_____________________