SOROPTIMIST INTERNATIONAL VISALIA FUND REQUEST APPLICATION

Thank you for thinking of Soroptimist as a resource to fund your project to improve the lives of women and girls. Please complete this application and ensure all requested information is addressed. If you have any questions please email us here. Once a decision is determined you will be contacted --all requests are subject to approval.

SOROPTIMIST MISSION AND CORE VALUES

Soroptimist Mission: Soroptimist is a global volunteer organization that provides women and girls with access to the education and training they need to achieve economic empowerment.

Core Values:

Gender Equality: Women and girls live free from discrimination
Empowerment: Women and girls are free to act in their own best interest
Education: Women and girls deserve to lead full and productive lives through access to education
Diversity and Fellowship: Women from varied backgrounds and perspectives work together to improve the lives of women and girls.

Fund Request Application

Date

MM

DD

YYYY

Name of Organization

IRS Tax ID Number

Organization's Mission/Purpose

Request and rationale

Fully describe the request and rationale for the request (250 word limit)

Total cost of project

$

Amount requested of SI Visalia

(up to $500)

$

Date funds needed

MM

DD

YYYY

Alignment with SI Mission and Core Values

Fully describe how potential funding for this project aligns with the Soroptimist Mission and/or Core Value(s). Please be specific in addressing each of them that apply. Refer to the Mission and Core Values listed above in completing this section. (250 word limit)

Optional information

If appropriate, provide other specific information that would assist in the assessing of your request (optional)

If funded, will Soroptimist International of Visalia be publicly acknowledged?

YES

NO

Contact Name

First Name

Last Name

Contact Title

Email Address

Phone

(###)

###

####

Website

http://

Mailing Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country