Name: 2020-21 DISTRICT 7505 – SPECIAL DISTRICT GRANT PROPOSAL & APPLICATION FORM
Start: 2021-01-15T08:00:00-05:00
End: 2021-03-01T17:00:00-05:00

Special District Grant

2020-21 DISTRICT 7505 – SPECIAL DISTRICT GRANT PROPOSAL & APPLICATION FORM
District Grants are used by District 7505 to support service projects of individual Clubs of District 7505. Clubs apply to the District 7505 Special District Grant Sub-Committee, which decides the merit of each application and the degree to which they will be funded.

If approved the District will match the approved amount up a maximum of $1,000.00. An application is not a guarantee for a grant!
Is this an original application, updated or changed to new application?*
- Original Grant
- Updated Grant
- Changed to New Grant
The District 7505 Special Grants Guidelines
District Grants must comply with the Terms and Conditions of The Rotary Foundation, including the Mission of the Rotary Foundation.

District 7505 Guidelines

Projects must fall within one of the following seven areas of focus:
•Peace and conflict prevention/resolution
•Disease prevention and treatment
•Water and sanitation
•Maternal and child health
•Basic education and literacy
•Economic and community development
•Environment (New)

All Projects must be sustainable.

Project proposals received by March 1, 2021 to be considered for this Special District Grant Program. Proposals received after that date may be considered if funds still available.

•Applications must be for an "original project" never done before by your club; prior grants and existing/recurring projects by your club will not be accepted.

•The budget for a project must be submitted with this application.

•No single club may receive more than $1,000 of matching Special District Grant funds for projects during the Rotary year.

•An application is not a guarantee for receiving a District Grant!
District 7505 Evaluation Criteria
Proposals will be evaluated taking the following criteria into consideration.
•Club Contribution (the amount of funds the club is contributing) can be more than $1,000, but the maximum amount from the District is $1,000.
•Members’ Hands-On Involvement: How many hours will Rotarians contribute to the success of this project?
•Impact of the project in the community: What will be the impact on the individuals being served by this project?
•Club Cooperation: Where clubs are encouraged to work together on projects.
Time Lines for Application and Execution of Projects
•Applications for the 2020-2021 Rotary year must be received by March 1, 2021.
•Review - Applications will be reviewed by the District Grants Sub-Committee in March 2021.
•Notification – The Committee aims to notify Clubs of award decisions at the end of March 2021.
•Funds will be presented to successful clubs as soon as the final decision is made.
•Project Execution - Clubs should strive to have projects completed by June 30, 2021.
•Reporting - A final report is due no later than two months after the completion of a project.
•Documentation – Club reports and supporting documentation for all expenditures must be maintained by the club for at least five (5) years following closure of the Special District Grant Project .
Contact Information
A PROPOSAL FROM THE ROTARY CLUB OF*
REQUIRED... select your Rotary Club from the Dropdown List. This Rotary Club will be referred to as the "Primary Rotary Club".
Date of Submission*
Date Format: MM slash DD slash YYYY
Prime Rotarian Contact*
You will be the Prime Rotarian Contact for this Grant Application.
First Last
Email*
Enter Email Confirm Email
Preferred Phone Number*
Address where the check will be sent*
Special Grant Check will be sent to this address.

Street Address Address Line 2 City State ZIP Code
Project Information
Project Title*
Name of your Project.
Area of Focus*
Select one (1) only
- Peace and conflict prevention/resolution
- Disease prevention and treatment
- Water and sanitation
- Maternal and child health
- Basic education and literacy
- Economic and community development
- Environment (New)
Short Project Goal/Synopsis*
Please describe in a few sentences what your project is about and what your ultimate goal will be.
Project Finance
Total Project Budget*
What is the anticipated cost of your project.
Project Financing*
Click on the (+) sign to add additional information
1. Primary Club Cash Contributions
2. Other D7505 Clubs Cash Contributions
3. Other Organizations/Individual Cash Contributions
4. District Grant Fund Request
Primary Club Cash Contributions Other D7505 Club Cash Contributions Other Organization/Individual Cash Contributions District Grant Fund Request
Project Budget Breakdown*
Click on the (+) sign to add additional information.

Any unused funds must be returned to the District!
Item Supplier Amount
Rotary Club Partners*
Are there any other District 7505 Rotary Clubs Partnering with you on this project
- Yes
- No
Rotary Clubs Involved*
List the names of the Rotary Clubs who are helping your club financially.
COOPERATING ORGANIZATIONS
If the project involves a cooperating organization, please provide the name of each Organization below and attach a letter of participation from each Organization that specifically states its responsibilities and how Rotarians will interact with each Organization in the project. By signing this application the Rotarian sponsor endorses the organization as reputable, responsible, and acting within the law.
Non-Rotary Partners/Individuals Involved*
Are there any other Partner Organizations or Individuals contributing financially to this project?
- Yes
- No
Non-Rotary Organizations/Individuals Involved*
Click on the (+) sign to add additional information
List the names of the Organizations and/or Individuals who are helping your club financially.
Cooperating Organization Letter of Participation*
Provide letter in the following extensions only. pdf, jpg, png.

Multiple files (up to 5) can be uploaded. Maximum file size of 32MB
Drop files here or

Accepted file types: jpg, png, pdf.
Project Description
Project Location*
Name of Municipality, Organization, Park, etc. Street Address, no PO Box City State Zip
Project Start Date*
Date Format: MM slash DD slash YYYY
Project Completion Date*
Date Format: MM slash DD slash YYYY
HOW WILL THIS PROJECT BENEFIT THE LOCAL COMMUNITY?*
Please describe the benefits for the local community from this project.
ROTARIAN PARTICIPATION*
Please, describe any non-financial participation by Rotarians in the project, incl. an estimate of hands-on hours
ROTARIAN HOURS WORKED*
Provide estimated hours that Rotarians worked at the project.
OWNERSHIP OF EQUIPMENT, MATERIALS OR SUPPLIES
Who will own equipment, materials, or supplies?*
Materials and supplies may not be owned by a Rotary club
Who will be responsible for maintenance, operating, and/or cost of the equipment/supplies?*
PROJECT CONTACTS
The Primary (applying) Club must appoint a committee of at least three (3) additional Rotarians from the Club to oversee the project. The committee members must be committed for the duration of the grant process. Please provide the name, mailing and email address, and phone number for all committee members. The primary contact will receive all official communication from District 7505 and should be prepared to disseminate this information to the other committee members.
1. Committee Member Name*
First Last
Address*
Street Address Address Line 2 City State ZIP Code
Email*
Enter Email Confirm Email
Phone*
2. Committee Member Name*
First Last
Address*
Street Address Address Line 2 City State ZIP Code
Email*
Enter Email Confirm Email
Phone*
3. Committee Member Name*
First Last
Address*
Street Address Address Line 2 City State ZIP Code
Email*
Enter Email Confirm Email
Phone*
ROTARY SYMBOLS
How will the general public know this is a Rotary sponsored project?*
Please provide details about publicity in a newspaper, display of the Rotary wheel or other activity.
AUTHORIZATION
Progress and Final Reporting Requirements
The Primary Rotary Club is required to complete and submit the FINAL REPORT, to the Special District Grant Sub-Committee.

THE FINAL REPORT WILL BE AVAILABLE ON MONDAY, JANUARY 25TH ON THE DISTRICT WEBSITE.
Club President’s Authorization - As president of the Rotary Club of*
I hereby affirm that the club has voted to undertake this project as an activity of the club.
Current Club President's Name*
First Last
Address*
Street Address Address Line 2 City State ZIP Code
Preferred Phone Number*
Email*
Enter Email Confirm Email
Please Contact:
PDG Tom Fletcher, D-7505 Special District Grant Sub-Committee Chair
288 Egg Harbor Road, Ste 9
Sewell, NJ 08080
[email protected]

Only applications received by March 1, 2021 will be considered. An application is not a guarantee for a Special District 7505 Grant!

2020-21 DISTRICT 7505 – SPECIAL DISTRICT GRANT PROPOSAL & APPLICATION FORM

January 15 @ 8:00 am - March 1 @ 5:00 pm

Special District Grant

2020-21 DISTRICT 7505 – SPECIAL DISTRICT GRANT PROPOSAL & APPLICATION FORM

The District 7505 Special Grants Guidelines

District 7505 Evaluation Criteria

Time Lines for Application and Execution of Projects

Contact Information

Project Information

Project Finance

COOPERATING ORGANIZATIONS

Project Description

OWNERSHIP OF EQUIPMENT, MATERIALS OR SUPPLIES

PROJECT CONTACTS

ROTARY SYMBOLS

AUTHORIZATION

Details

Organizer

Details

Organizer

Event Navigation

Primary Club Cash Contributions	Other D7505 Club Cash Contributions	Other Organization/Individual Cash Contributions	District Grant Fund Request

Item	Supplier	Amount