Foundation Grant Application

This is a request for funds over $1,000 from the Racine Founder's Club Rotary Foundation, Inc., which will be reviewed by the board of directors. Do not apply if your group does not desire to have its complete operation reviewed on this process.

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Grant distribution for this fiscal year has been closed. All grant submissions received as of 05/01/25 will be reviewed for consideration after 09/01/25.

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Organization Name

Address

City/Town

State/Province

ZIP/Postal Code

Name of President

Name of Director

Current list of Board of Directors

Number of Paid Employees

Number of Volunteers

Contact Person

Name

Title

Telephone

Email Address

Funding

Does your agency have a federal tax-exempt status?

Attach a copy of the Internal Revenue Service ruling or determination letter, if not attached, please explain.

One file only.
5 MB limit.
Allowed types: jpg png pdf doc docx.

Project Title

Lack of Internal Revenue Service ruling or determination letter explanation

Amount Requested

Amount Approved

Date Established

How did you become aware of the Racine Founders Club Rotary Foundation, Inc. and its grant program?

Project Information

Total Annual Budget of the Organization:

Type of project:

Total cost of the project

Funds requested

Total Financial Support Received Last Fiscal Year:

The Racine Founders Club Rotary Foundation, Inc. mission establishes several broad categories of community need. Please indicate by checking the category, which in your view is appropriate for your grant application.

Project Start Date:

Total Financial Support Received Last Fiscal Year From Memberships:

Project End Date:

Describe the project for which you are seeking funds. Please include specific objectives of the project.

Total Financial Support Received Last Fiscal Year From Foundations:

How was need determined and how will the project respond to this need?

Indicate your organization’s special qualifications to address these needs.

Total Financial Support Received Last Fiscal Year From United Way:

Describe your project evaluation plan. Be very specific about who will evaluate it, the expected completion date for the objectives, and the criteria for judging success.

Total Financial Support Received Last Fiscal Year From Government Programs:

List other sources of support being approached. If necessary, attach list.

Are your financial records subject to an audit?

Source

Amount Requested

Current Status

If yes, is a copy of the audit available upon request?

Attach List Here

One file only.
50 MB limit.
Allowed types: jpg png pdf doc docx.

If the project is ongoing, please identify future pending sources for succeeding years or the duration of the project.

Fund Raising Activities:

Certification

Within 30 days following completion of the project, we will submit a summary report including an accounting of all expenditures.
We will provide additional project or organization information if so requested.
This grant application has been authorized by the organization’s governing body or chief executive.

Name

Contributions:

Title

Required Attachments

Total Financial Support Received Last Fiscal Year From Individuals:

Current financial statement (balance sheet and statement of operations)

One file only.
50 MB limit.
Allowed types: jpg png pdf doc docx.

Detailed agency budget – current year

One file only.
50 MB limit.
Allowed types: jpg png bmp pdf doc docx.

Total Financial Support Received Last Fiscal Year From Corporations:

Detailed project budget

One file only.
50 MB limit.
Allowed types: jpg png pdf doc docx.

Copy of the Internal Revenue Services ruling or determination letters of status under Section 501 © (3) and 509 (a) of the Internal Revenue Code.

One file only.
50 MB limit.
Allowed types: jpg png pdf doc docx.

List previous grant applications to Racine Founders Club Rotary Foundation, Inc. during the last five years.

Date of Application