Yayasan Support Grant Program

Yayasan Support Grant Program

Application Form
Date of Application

DayMonthYear
Latest by 31st October 2024
Club Name(s)*
Name
Email *
example@example.com
Mobile
Project Title
Aligned to Focus Area
Grant Amount
Max RM20,000 per club
Project Description
Main Objectives and Beneficiaries
Needs Assessment
Describe how needs are identified
Location
Must be in Club Locality
Project Start & End Date
Maximum 3 months
Partners and their roles
Participating Organization's details
Describe roles of Club Rotarians
Public Image Efforts
Promoting YKKRM image
Please note that this form consists of 2 pages. The first page collects Basic Information, and the second page gathers Information on the project. Please upload all relevant documents.

You will receive a confirmation email once your application is submitted, and a pop-up message will appear on your screen. Please check your inbox, including your spam folder, for the confirmation Email.

Budget

Funding

Vendor Bank Account Details
Yayasan pays directly to vendor, please update vendor bank information. Upload Proforma Invoice/s, Invoice/s below.

Vendor Details

**Yayasan reserves the right to change the terms and conditions contained here-in.
Declaration :*

Please indicate possible areas of conflict of Interest such as suppliers of project components and/or beneficiaries are related to any club members (if any)Club is up to date on payment of Rotary International and District duesClub is a legal entity in their domicile jurisdictionTo abide by all Grants terms & conditions
I certify

I certify that all information entered above is valid and true.
Upload any relevant documents/Photos here.

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Presidents Name
Presidents Email
Secretary or President-Elect Name
Secretary or President-Elect Email
Report Submitted By
Email Id, who submitted the Report
Please note that this form consists of 2 pages. The first page collects Basic Information, and the second page gathers Information on the project. Please upload all relevant documents.

You will receive a confirmation email once your application is submitted, and a pop-up message will appear on your screen. Please check your inbox, including your spam folder, for the confirmation email.
Should be Empty:

Expense Detail