2021 Application for Funds
From the
Rapid City Cosmopolitan Club
 
Name of Organization______________________________________________________
 
Address__________________________________________________________
 
Contact Person and Phone Number _________________________________________________________________
 
E-Mail Address___________________________________________________________
 
Amount Requested $_______________

What percent of your total budget will this amount equal?  _________________

Have you received funds from the club before?    Yes        No
 
Purpose for the funds if they are received:
 
 
 
 
 
 
 
 
 
Other Funding Sources:
 
 
 
 
 
 
 
Copy of a financial statement should be attached.
 
Date submitted _______________
 
Cosmopolitan Club use only:
 
Date received _______________Deadline May 31, 2021
 
Mail to Rapid City Cosmopolitan Club   
Attn: Funds Distribution Chairperson    
P.O. Box 994   Rapid City, SD 57709