Staff Form

Staff Grant Application

NOTE: This form does NOT save work when closed! As a precaution, type everything in a word processing application, save, and then copy and paste to this application.

Information

* Indicates required field

Name *

First

Last

Email *

Phone Number *

Event/Class/Seminar Information

Program Name *

Program Location *

Line 1

Line 2

City

State

Zip Code

Country

Program Website (If Available) *

Registration Deadline Date *

Program Start Date *

Program End Date *

For What Purpose Will The Grant Be Used?

To ensure full consideration all supporting information is required such as brochure, website, camp application form, outlining the event/program/camp and costs. *

What Do You Hope To Learn And Accomplish From This Experience?

Be detailed : How will this activity benefit you and/or the RB community? *

Expenses

Please list all expenses you expect to incur.

Travel *

Lodging *

Meals *

Registration Fee *

Miscellaneous Expenses *

TOTAL *

Additional Funds

Have you secured funds from other sources? *

What is your contribution? (If $0, please explain.) *

Request Information

Amount you are requesting from the RBEF? *

Payment Option *

Please pay organization directly. Please pay grant recipient directly (To be reimbursed, confirmed registration AND receipts for expenses are required).

Based on payment option, include the appropriate address *

Line 1

Line 2

City

State

Zip Code

Country

If I am awarded a grant, I commit to being interviewed and also working the phone bank at the 2022 Telethon. (Most likely, next year's telethon will take place on Saturday, March 5 or 12 of 2022, so please mark your calendar now as a reminder.) *

I understand.

Submit Application

Staff Grant Application
Due Date - extended to Tuesday, May 4
Notifications - friday, May 7

Staff Grant Application

Information

Event/Class/Seminar Information

For What Purpose Will The Grant Be Used?

What Do You Hope To Learn And Accomplish From This Experience?

Expenses

Additional Funds

Request Information

By-Laws

Insurance 2020-2021.pdf

501(c)(3)

Staff Grant Application Due Date - extended to Tuesday, May 4 Notifications - friday, May 7

Staff Grant Application

Information

Event/Class/Seminar Information

For What Purpose Will The Grant Be Used?

What Do You Hope To Learn And Accomplish From This Experience?

Expenses

Additional Funds

Request Information

By-Laws

Insurance 2020-2021.pdf

501(c)(3)

Staff Grant Application
Due Date - extended to Tuesday, May 4
Notifications - friday, May 7