ROTARY CLUB OF DUNCANVILLE - Application to request funds                                                          - Please print form and submit to address below

Organization requesting funds:  _______________________________________________

Address: ________________________________________________                                                   ________________________________________________

Person Submitting Request : ________________________________________________

Office/Title:_________________ Phone: _________________________

Amount Requested: ______________ When Needed: ______________

Describe in detail how funds will be used, who will benefit, and how they will benefit

__________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________ __________________________________________________________________________________

What other sources of funds do you have available for this project? ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________

Requests must be submitted by April 15 for consideration for the next Rotary Year (July 1 - June 30).  Mail to: Rotary President, P.O. Box 380837, Duncanville, TX 75138-0837

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