Let us know when you are considering undertaking a Global Grant project, as you will need to know that there are funds from District available in the form of DDF. Speak to us first, then complete this form to ensure your project is in the pipeline.

Appendix E




District 1175 – Global Grant

First Step Application to District


Submit this first step application for a Global Grant, by e-mail at any time, to one of the Joint-Chairs, District Foundation Grants Sub-Committee (DFGS-C):

·         West clubs (AG areas 1,2,3,4,5,6) – Ron Dickerson  moron.dickerson@gmail.com             

·         East clubs (AG areas 7,8,9,10,11,12) – Jim Cobley  jamesgcobley@tiscali.co.uk


Completion of this form, at any time, is a necessary first step to an on-line application to TRF for a Global Grant.  It will enable a critical assessment of the viability of the project’s purpose to be made by the District Grants Sub-Committee.


Answer as many questions as you can.



From the Rotary Club of                _______________________________             District 1175


In which country will the project take place?       ___________________________________.


Planned start                                     ________________________________________

and finish dates                                                ________________________________________


(It will take several months to prepare and submit an on-line application, and obtain approval from TRF)


Have you made contact with a partner club/district in the project area, or in another country if the project is planned to take place in D1175?                                                  Yes/No


Name of club and District             _______________________________________________.


Which Area of Focus will the project address?

1.                   Peace and conflict prevention/resolution            

2.                   Disease prevention and treatment

3.                   Water and sanitation

4.                   Maternal and Child health

5.                   Basic Education and Literacy

6.                   Economic and community development


Is your club qualified and able to sign the Memorandum of Understanding?                        Yes/No

Submit an MoU for 2016-17 with this application if you have not done so already.


Are your intended partner club and District qualified to apply for a Global Grant?              Yes/No

Give a brief outline of the project, including its objectives:









How much is the project estimated to cost, in the local currency and in US dollars – a fully detailed budget will be required when an on-line application is made.


The cost should include:

·         All materials, resources and on-site training necessary to meet the objectives of the project

·         Up to 10% for contingencies


The cost may include, although a thorough justification will be required when an on-line application is made:

·         An additional 10% for a Project Manager

·         An additional 10% to measure the project outcomes

·         The cost of the visit of two people to implement the project and support training


Local currency   _____________________        US$        ______________________


If the total cost of the project is less than $30,000 (£24,000 at current exchange rate) it will not be eligible for a Global Grant.


How much will your club put aside for this project?          __________________________


How much will you request D1175 to put aside?                __________________________


What are the intended outcomes of the project, and how are they sustainable?











In what ways will Rotarians from your club be involved in the work of the project?












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