EmailMe Form - Hamilton Rotary Grant Application

I am applying for:

A Minor Grant of up to $750

A Major Grant of up to $10,000

Applicant Organizational Name *

Registered Charity Number (if applicable)

Mailing Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Name of CEO/Executive Director *

First Last

Contact Name

First Last

ONLY COMPLETE IF the grant contact is NOT the Executive Director/CEO

Email Address *

Telephone *

### - ### - ####

Fax *

### - ### - ####

Website

How much is requested this application? *

Have you ever received a grant from us?

No

Yes, if so, in what year?

What services does your organization offer and for how long has your organization existed? *

No more than 100 words

What Geographical area do you serve in the city?

What Hamilton AM Rotary Club Priority Area are you addressing? Specifically, what will you use the funds for?