GRANT REQUEST FORM EASTON KIWANIS GRANT REQUEST FORMDOES YOUR REQUEST QUALIFY? PLEASE READ BEFORE COMPLETING THIS FORM. The Kiwanis Club of Easton’s priority focus is on serving children and youth in the Easton area. Capital project requests will be forwarded to our Kiwanis Club Foundation for its consideration. If a grant is provided, a final report is required regarding how funds were used within the fiscal year for general support, or within 60 days of a sponsored event. Pictures of events, if applicable, would be appreciated.ORGANIZATION'S NAME *CONTACT PERSON'S NAME *ADDRESS Street AddressApt, Suite, Bldg. (optional)CityState / Province / RegionPostal / Zip CodeAfghanistanAlbaniaAlgeriaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCentral African RepublicChadChileChinaColombiaComorosCongo (Brazzaville)CongoCosta RicaCote d\'IvoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast Timor (Timor Timur)EcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFijiFinlandFranceGabonGambia, TheGeorgiaGermanyGhanaGreeceGrenadaGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiKorea, NorthKorea, SouthKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorwayOmanPakistanPalestinian TerritoryPalauPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint VincentSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited States of AmericaUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamWestern SaharaWestern SamoaYemenZambiaZimbabweCountryPHONE CONTACT PERSON'S EMAIL *ORGANIZATION'S WEBSITE [http:// (your website)] YEAR ORGANIZATION WAS ESTABLISHED *ARE YOU AN APPROVED 501(C)3 BY THE I.R.S. *ENTER YOUR 501(C)3 NUMBER (no hyphens) AMOUNT REQUESTED (no dollar sign) *DATE NEEDED BY *HOW MANY CHILDREN/YOUTH WILL BENEFIT *WHERE IS THE PROJECT LOCATION TIME PERIOD FUNDS WILL BE USED WOULD YOU BE WILLING TO DO A PRESENTATION TO EASTON KIWANIS CLUB? *SPECIFIC PURPOSE OF THE FUNDS *DESCRIPTION OF PROJECT *ORGANIZATION'S MISSION *WOULD YOU OR A MEMBER OF YOUR ORGANIZATION OR BOARD CONSIDER MEMBERSHIP IN THE EASTON KIWANIS CLUB OR IS SOMEONE A MEMBER NOW? WHO? WOULD YOU OR A MEMBER OF YOUR ORGANIZATION OR BOARD CONSIDER SUPPORTING OUR FUNDRAISING EFFORTS OF THE EASTON KIWANIS CLUB? DOES THIS KIWANIS GRANT CONSTITUTE THE SOLE PROJECT FUNDING? WHAT OTHER GRANTS HAVE YOU APPLIED FOR? *IF THE KIWANIS CLUB CANNOT FUND YOUR REQUEST IN ITS ENTIRETY CAN YOUR PROJECT PROCEED WITH A REDUCED GRANT AMOUNT? *IF YES HOW WILL REDUCED FUNDING AFFECT THE PROJECT AS DESCRIBED ABOVE? PROVIDE VIA AN ATTACHEMENT THE PROJECT'S DETAILED BUDGET IDENTIFYING ALL FUNDING SOURCES. PRINTED NAME DATE OF APPLICATION Verification a person is completing this form is not a robot.Please enter any two digit number between 10 and 99. *Example: 12This box is for spam protection - please leave it blank:
