project form

ROTARY INTERNATIONAL, 2005 TRI-DISTRICT CONVENTION

DISTRICTS 4110- 5470, 5520

MATCHING GRANT - PROJECT FORM

. 1) Complete the form and "Submit"

. or

. 3) Download & print the form and send it to:

Loren Kuehne

District 5520, Executive Director

3265 Arrowhead Rd, #200

Las Cruces , NM 88011-4786

_______________________________________________________________________________________________

Tri-District Conference 2005

Proposal/Propuesta #

Project Name/Propuesta de Poryecto

Short Description/Descripción corta

Proposing club name/Nombre del Club

Proposing club #/Numero del Club

Disttrict/Distrito

Contact Person/Nombre del Contacto

Mailing Address/Direción:

City/Ciudad

Country/Pays

Phone/Telefono

Fax

E.mail/Correo Electrónico

Total $ Amount Needed/Suma $

Solicitada (Must be US$11,500 or greater)

All pledges for this project will be good until March 31, 2006.

Project Summaries may be mailed to the following address:

Loren Kuehne

District 5520, Executive Director

3265 Arrowhead Rd., #200

Las Cruces, NM 88011-4786

Tel: 505-522 3763

Fax: 505 522 3332

Download the Tri-Distritct project form

MS WORD
ACROBAT

Complete and bring the Rotary International Grant Application form 141en to the Tri-District Conference

Download RI Application form 141en

MS WORD
ACROBAT

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