EmailMeForm
Guidelines for Application
• Applications should include a letter of request and support materials, including a budget of the project and financial statements of the organization
• To be considered, the applicant must be located in Peel or the applicant’s request must directly benefit Mississauga residents.
• Rotary cannot fund ongoing operational activities.
• Rotary funding cannot be project critical (the project will fail or not go ahead without our funding).
• Rotary prefers fixed term projects or equipment with a one-year completion date.
• It is expected that recognition of Rotary’s assistance will be either attached to the item or the
program, which Rotary supports and recognized on social media.
• Funds must be used for the purpose described in the application unless a change is authorized by
the Rotary Club of Mississauga.
• Individual applications will only be considered if presented through a member of the Club.
Name of Charity
*
Charity Organization #
Name of Project
*
Project Deadline
MM
/
DD
/
YYYY
Name of Contact Person
*
First
Last
Email Address
*
Contact Telephone
*
###
-
###
-
####
Address
*
Street Address
Address Line 2
City
State / Province / Region
Postal / Zip Code
Antigua and Barbuda
Aruba
Bahamas
Barbados
Belize
Canada
Cayman Islands
Cook Islands
Costa Rica
Cuba
Dominica
Dominican Republic
El Salvador
Grenada
Guatemala
Haiti
Honduras
Jamaica
Mexico
Netherlands Antilles
Nicaragua
Panama
Puerto Rico
Saint Kitts and Nevis
Saint Lucia
Saint Vincent and the Grenadines
Trinidad and Tobago
United States
Argentina
Bolivia
Brazil
Chile
Colombia
Ecuador
Guyana
Paraguay
Peru
Suriname
Uruguay
Venezuela
Albania
Andorra
Armenia
Austria
Azerbaijan
Belarus
Belgium
Bosnia and Herzegovina
Bulgaria
Croatia
Cyprus
Czech Republic
Denmark
Estonia
Faroe Islands
Finland
France
Georgia
Germany
Greece
Hungary
Iceland
Ireland
Italy
Kosovo
Latvia
Liechtenstein
Lithuania
Luxembourg
Macedonia
Malta
Moldova
Monaco
Montenegro
Netherlands
Norway
Poland
Portugal
Romania
San Marino
Serbia
Slovakia
Slovenia
Spain
Sweden
Switzerland
Ukraine
United Kingdom
Vatican City
Afghanistan
Bahrain
Bangladesh
Bhutan
Brunei Darussalam
Myanmar
Cambodia
China
East Timor
Hong Kong
India
Indonesia
Iran
Iraq
Israel
Japan
Jordan
Kazakhstan
North Korea
South Korea
Kuwait
Kyrgyzstan
Laos
Lebanon
Malaysia
Maldives
Mongolia
Nepal
Oman
Pakistan
Palestine
Philippines
Qatar
Russia
Saudi Arabia
Singapore
Sri Lanka
Syria
Taiwan
Tajikistan
Thailand
Turkey
Turkmenistan
United Arab Emirates
Uzbekistan
Vietnam
Yemen
Australia
Fiji
Kiribati
Marshall Islands
Micronesia
Nauru
New Zealand
Palau
Papua New Guinea
Samoa
Solomon Islands
Tonga
Tuvalu
Vanuatu
Algeria
Angola
Benin
Botswana
Burkina Faso
Burundi
Cameroon
Cape Verde
Central African Republic
Chad
Comoros
Democratic Republic of the Congo
Republic of the Congo
Djibouti
Egypt
Equatorial Guinea
Eritrea
Ethiopia
Gabon
Gambia
Ghana
Gibraltar
Guinea
Guinea-Bissau
Cote d'Ivoire
Kenya
Lesotho
Liberia
Libya
Madagascar
Malawi
Mali
Mauritania
Mauritius
Morocco
Mozambique
Namibia
Niger
Nigeria
Rwanda
Sao Tome and Principe
Senegal
Seychelles
Sierra Leone
Somalia
South Africa
Sudan
Swaziland
United Republic of Tanzania
Togo
Tunisia
Uganda
Zambia
Zimbabwe
Country / Region
Total amount of funding request (max. $5k)
*
Cheque made payable to:
*
Describe how the funds will be used:
*
Who will be served by this request?
Do you receive government funding or funding from United Way?
*
Yes
No
Does your service compete with private enterprise or any other community services?
*
Yes
No
I don't know
If your request is intended to be supported by others in addition to Rotary, please describe how you expect this will happen and result to date:
Have you sent this request to other Rotary Clubs? If so, which ones:
Is there any other way the Rotary Club of Mississauga can be involved with/interact/learn about your project/organization beyond the distribution of funds? (I.e. volunteers for project, speaker for Rotary meeting):
Is there any way you can assist Rotary in letting the community know of our assistance and thus the work of Rotary?
Is there a name of a Rotarian supporting this request?
First
Last