Project & Grant Evaluation Application Form

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Responses to this form will be transmitted to the Project & Grant Evaluation (P&GE) Committee Chair. The deadline for club project applications is February 15th each year for the Rotary year beginning in July of the same year. Please complete the form, provide as much information, and click the Submit button located at the bottom left of this form. Any questions, please contact PGE Chair Victoria Grasso at victoria.grasso@cooperfoundation.org.

Email *

1. Project Name *

2. Date (s) of Project *

YYYY

3. Contact Person *

4. Responsible Rotary #14 Committee *

5. Total Cost of Project *

6. Amount of Funds Requested *

7. Name of organization/individuals to which/whom payment will be made *

8. Budget - provide a line-item budget for how funds will be used *

9. Other Sources of Funding, if any (including matching funds, if applicable) *

10. Optional - If continuation funding is needed beyond this year, please indicate sources and amounts for future year(s) funding:

11. Description of Project: *

12. List ways the project will impact the community and how it is compatible with Rotary’s goals: *

13. Estimated number of project beneficiaries: *

14. Estimated number of Club 14 volunteers needed: *

Questions 15 to 18 for Previous and Existing Club Projects Only. Please complete the following additional information:

15. Optional - Provide a summary of the history of the project/event/activity. Include the original start date of the project, if applicable. Indicate how well the project/event/activity met its goals and objectives. Specify any changes to be made which will improve effectiveness and/or outcomes.

16. The number of people served by this project last year (and/or previous years, if applicable).

17. The number of Rotary volunteers participating in this project last year (and/or previous years, if applicable).

18. Please share any outcome information/grant reports regarding this project, if available (how lives have been changed or impacted; implications over multiple years, etc.)

A copy of your responses will be emailed to the address you provided.

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