2021 Application for Funds
From the
Rapid City Cosmopolitan Club
Name of Organization______________________________________________________
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