Community Grant Application Form

This application is for charitable organizations in the greater Hattiesburg area who are in need of funds for operations, special projects, or supporting constituents of the organization. Note: these fund are not eligible for for-profit organizations, individuals, or needs beyond the scope of Rotary's values and mission.

Please complete the following application. Applicants will be considered by the Rotary board as recipients of its annual fundraising efforts.

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* 1. Applicant Name

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* 2. Address

Name

Company

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Country

Email Address

Phone Number

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* 3. Is the applicant a registered, non-profit organization in the State of Mississippi?

Yes

Community Grant Application Form

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* 1. Applicant Name

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* 2. Address

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* 3. Is the applicant a registered, non-profit organization in the State of Mississippi?

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* 4. Number of employees

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* 5. Average number of monthly volunteers

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* 6. Total annual budget income

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* 7. Please describe the nature of the applicant's charitable efforts.

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* 8. Please describe the nature of the funds requested. Be specific as to what they will be used to support.