Rotary Club of PearlandCommunity Impact Grant Program

Rotary Club of PearlandCommunity Impact Grant Program
School/Teacher/Student Organization Application
Applicant Type
Applicant Type Options
Applicant Information
School Name:
School Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Principal Name & Email:
Applicant's Name & Title:

First NameLast Name
Applicant's Phone Number & Email:
Name of School Club or Student Organization (if applicable):
Name of Teacher Sponsor for School Club or Student Organization:

First NameLast Name
Teacher Sponsor Phone Number & Email:
Verification
If you are a teacher, are you currently employed by the school listed above?

High School
Postsecondary
Urgency & Timing
How urgent is funding for this project or initiative?
What impact would delayed funding have on your project or need?
Project Information
Project / Initiative Name:
Total Funding Amount Requested:
Estimated Number of People Impacted:
Describe how the funds requested will be used and how your project will fill an educational need or challenge:

Budget Section

Other Funding Sources
Have you applied for or received funding from another source for this same project?

If yes, please provide the source of funding, amount received, and status of the request:
Volunteer & Community Engagement
Will volunteers be involved?
If yes, please describe the involvement:
How will this project positively impact the Pearland community?
Rotary Connection
Was this application referred by, sponsored by, or discussed with a member of the Rotary Club of Pearland?
If yes, please provide the member's name:

First NameLast Name
Do any employees, volunteers, or immediate family members of your organization have a personal, family, financial, or professional relationship with a member of the Rotary Club of Pearland?
If yes, please identify the member(s) and describe the relationship: