Assistance Request

The Rotary Club of Cairns West regularly provides financial donations and services to other not-for-profit organisations within the Cairns region. If your organisation would benefit from our assistance, please fill out the below form and our Club will process your application at our next Board meeting.

Who is this application for?

Who is the beneficiary of this application?

Does the beneficiary know this application is being submitted?

Name

Phone

What would you like to request?

Financial Assistance Volunteer Assistance

If financial, what value are you requesting?

If volunteers being requested, please detail what’s required?

Is there a date?

Why do you need this help

What will this help achieve?

Have you received assistance from another source?

Do you have any additional comments

To the best of my knowledge and belief the information provided in this application is true and correct

To the best of my knowledge and belief a full and accurate disclosure of income and expenditure for the project proposed has been made herein

Submission of an application does not guarantee approval for either all or part of the assistance being requested

Incomplete applications cannot be processed

Any further information deemed necessary to properly assess this application will be provided within 5 working days

I acknowledge that further Approval Conditions may apply (eg copies of expense invoices, presentation at a Club meeting etc)

The applicant agrees to the above and is authorised to make this acceptance on behalf of the beneficiary.

Assistance Request

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