Date: 

Amount Requested: 

Name of Organization/Activity/Project: 

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Purpose of Organization/Activity/Project:

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Intended use of funding:

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How will the funding benefit the community:

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What investment of time, services or funds are being made by others:

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How many people will the grant help and what are their demographics? (Ages, Zip Codes, Income Levels):

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Who and how many Aurora Rotarians are involved in the project and what is their role:

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Name, Address and Phone Number of sponsoring applicant: