Kiwanis Club of Dubuque

KIWANIS CLUB OF DUBUQUE

 FUNDING REQUEST APPLICATION

The Dubuque Downtown Kiwanis Club annually distributes funding to local organizations that serve needs within our community.  We favor funding specific projects or special programs that will directly affect youths or needy persons in our community.  We generally do not fund expenses directly related to the normal day-to-day operations of an organization.  Please be aware that requests for financial assistance may be funded fully, partially, or not at all.  Funds are generally distributed between January 1^st and September 30^th of the following year.  Organizations desiring to apply for funds during this period must complete the following application and submit it not later than November 15th to:

Funding Request

Dubuque Downtown Kiwanis Club

P.O. Box 563

Dubuque, IA  52004-0563

Note: As a service organization dedicated to children; most of our service funding goes to youth service projects. A smaller, but significant portion goes to community service projects. Please indicate which funding you seek:

___Youth Service

___Community Service

I.  Applicant Organization Information:

Name of Organization __________________________________________________________________

Address (Street or PO Box) _____________________________________________________________

City ____________________________     State  _____________________     ZIP+4 ________________

Telephone ___________________________________     Email ________________________________

Name and Title of Contact Person ________________________________________________________

Telephone ___________________________________     Email ________________________________

Provide a brief description of your organization, its purpose, and activities:

                                                                                                                                         II.  Project or Program Information:

Provide a description of the specific project or program for which funds are being sought and summarize proposed activities.  Describe the population to be served and how it will benefit.  Indicate the number of individuals expected to be impacted.

III.  Project or Program Funding:

Indicate the grand total of dollars needed to support the project or program:

Indicate the amount of dollars your organization is requesting from the Kiwanis Club to support the project or program:

Indicate the date when funds to support the project or program are needed by your organization: 

If your project or program is funded, indicate how the Dubuque Downtown Kiwanis Club will receive recognition from your organization:

Name and Title of Person Submitting this Application _________________________________________

Signature __________________________________________     Date ___________________________