Grant Application | Visalia Rotary Community Foundation

Please note that there are 2 options:

- a form you can download, print, complete and email to us or

- a fillable form you can submit from this site

The Foundation supports grantees within the City of Visalia and entities that have an impact on the City of Visalia.

Applications are ONLY accepted between March 1st and May 15th of each year.

Grant Application Form

Requesting Organization

Organization Address

Multi-line address

Country/Region

Address

City

Zip / Postal code

Primary Contact Person (Name and Title)

First name

Last name

Telephone

Cell Phone

Email

Incorporated as Non-Profit?

Yes

No

Date Incorporated

Tax Exempt Status

Yes

No

Has your organization qualified as a Tax-Exempt Entity under State Law and Section 501(c)(3) of the Internal Revenue Code?

If yes, list TIN

Geographic area you serve?

Number of Persons Served

Grant Request

Total Amount Requested

Brief Description of Proposed Use of Funds

These funds will be used to address

Duration of Effect

What will be the expected duration of effect from the grant?

Start and Completion

What are your proposed start and completion dates for use of this grant?

Project Dependency?

Yes

No

Without the VRCF Grant, does your project go forward anyway?

Funding Alternatives

Yes

No

Are there alternative sources of funds for the project?

Results Reporting

How and when will you report your results to the VRCF?

Additional Info

If needed, please e-mail us with additional information.

Board of Directors & Mangement

Contact Person (Name and Title)

Contact's Phone

Chair

Chair's Name

First Name

Last Name

Vice-Chair

First Name

Last Name

Treasure

First Name

Last Name

Secretary

Secretary's Name

First Name

Last Name

Committee Meeting Frequency

Please indicate the number of executive committee meetings each year.

Board Meeting Frequency

Please indicate the number of Board of Director's meetings each year.

Do you utilize volunteers?

Yes

No

Full Time Volunteers

If you utilize volunteers, how many are full time?

Part Time Volunteers

If you utilize volunteers, how many are part-time?

Outside Fund Raisers

Yes

No

Are outside fund raisers employed?

Paying Outside Fund Raisers

If you use outside fund raisers, on what basis are they paid?

Are Accounts audited by:

A certified public account

An auditing committee of the Board

Other

If OTHER account audit type

If you selected OTHER in the previous question about accounts are audited, please describe it here.

Certification

Your initials

Verification of Accuracy

Yes

I certify that the aforementioned and enclosed information is complete and accurate. (To be signed by the Chair of the Board, or other Board Member). Your initials, plus the IP address and server date stamp on this form at the time of submission serves as your signature.)

Signature

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501(3)(c) Status Letter

Please e-mail or upload a copy of your IRS 501 (c ) ( 3) Status letter, if applicable, in addition to completing this application.

A Few Past Grant Recipients

Applications due yearly on May 15th

Apply For Grant

Visalia Parks & Recreation Dept.