Online Application

The Parole Rotary Foundation is accepting applications for its 2025-26 program year. Applications are due January 31, 2025. For more information, please refer to the Application Guidelines posted here.

Name of Organization: *

Parent Organization (if different):

Organization Address:

Address Line 1

Address Line 2

City

--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingState

Zip Code

Name of Executive Director: *

Executive Director Phone: *

Previous Parole Rotary Foundation Grantee: *

• No
• Yes

Executive Director Email: *

Total Organization annual revenue: *

Program Name: *

Phone *

Name of Program Director (primary contact): *

Email *

Brief descriptive title of your proposed program: *

Provide descriptive title that summarizes the program. (use 60 characters or less)

Brief Program Summary: *

Provide up to 75 words that concisely summarize program objective(s), target beneficiaries, and anticipated impact(s).

Total Program Budget: *

Funds Requested from Parole Rotary Foundation: *

Estimated number of AA county residents to be served by Parole Rotary Grant *

Population served – check all that apply: *

• General population
• Low income/welfare
• Homeless
• Student
• Other

If Other, please specify

Ages served – check all that apply:

• All
• <12
• 13-19
• 20-34
• 35-65
• >65

Program End Date: *

Date Program Start Date: *

Primary category of request – check one category *

• Education
• Arts
• Health/Wellness

Type of activity funds are requested *

• Service: work effort benefiting children, e.g. teaching, counseling, …
• Capacity Building: projects leading to lasting infrastructure that benefit children, e.g. sports equipment, trail building, bookshelves, ….
• Welfare: goods distributed to benefit children, e.g. food, clothes, scholarships, …

File Upload - Attach Application Narrative *

Click or drag a file to this area to upload.

Upload Application Documents: Documents may be submitted in PDF and/or MS Word format.

File Upload - Attached Budget Details *

Click or drag a file to this area to upload.

Upload Application Documents: Documents may be submitted in PDF and/or MS Word format.

File Upload - Attach 501(c)(3) Certificate *

Click or drag a file to this area to upload.

Upload Application Documents: Documents may be submitted in PDF and/or MS Word format.

File Upload - Attach most recent IRS Form 990 *

Click or drag a file to this area to upload.

Upload Application Documents: Documents may be submitted in PDF and/or MS Word format.

By signing below, you affirm that your organization does not discriminate by race, creed, gender, sexual orientation, age, religion, disability, or national origin.

Signature

Clear Signature

Upon receipt of your application, the Program Director, (primary point of contact) will receive an email acknowledging your grant application was submitted.

Submit Application