1. District Simplified Grant Information

3. APPROPRIATE IMPLEMENTATION (see References below for more details) 1. Satisfy real humanitarian needs or community enhancement projects 2. Promote active participation from large number of club Rotarians 3. Development of strong Rotary networks 4. Funds should be used to purchase budgeted and itemized humanitarian goods. 5. Funds not used to benefit Rotarians

4. District Simplified Grant Information

8. Grant Certification District 5790 District Simplified Grants

9. The Reasoning In several years, we will be transitioning into Future Vision. Grant Certification will be a requirement. Our grants will be administered at the district level Grant Certification will standardize the process

10. The Application Process 2011-2012 District 5790 Rotary International District Simplified Grant Application For grant requests of US$1200.00 or less using District Simplified Grant proceeds from The Rotary Foundation) Rotarians may use this application and attach additional pages as needed or may answer the questions below on blank paper; on the condition the answers follow the same order as the application. Incomplete applications will be returned to the primary host partner with a brief explanation. The date of the application will be considered as the date at which a complete accurate application is received. Note: Application of these funds must conform to the requirements and limitations established by The Rotary Foundation for District Simplified Grants in every particular. 1. PROJECT DESCRIPTION 1. What is the purpose of this project? Provide a brief description. 2. How will it meet the needs of the community? What is the humanitarian component?

11. 1. PROJECT DESCRIPTION 1. What is the purpose of this project? Provide a brief description. The club will initiate a literacy project working with teachers and administrators in four Rotary area elementary schools. The Rotary club will provide 3 rd grade students in each of these schools with dictionaries. Rotarians will request a progress report on how students utilize the dictionaries 2. How will it meet the needs of the community? What is the humanitarian component? The students of Rotary Elementary Schools are in a socio economic challenged area of the city. Providing dictionaries offers a needed tool for the students especially since such an item is not readily available to the students.

12. 3. If applicable, How will the host and international partners communicate and work together to implement this project? Please provide specific examples of activities. N/A 4. Describe how your club will be actively involved in this project. The project should involve as many Rotarians as possible. Rotarians will contact elementary school teachers to verify the need of the dictionaries. The club will purchase the dictionaries and then apply Rotary labels with the club name. Rotarians will make a formal presentation to the students before distributing the books. Rotarians will also request a progress report from the teachers on the use of the dictionaries. Approximately 25 Rotarians will be involved in the project.

13. 2. COOPERATING ORGANIZATIONS If this project involves a cooperating organization: 1. Provide the name of the organization below. 2. Attach a letter of participation from that organization that specifically states its responsibilities, how it will interact with Rotarians in this project, and the organization's agreement to cooperate in any financial review of activities connected with the project. Name of organization ABC Book company __x__ Letter of participation from organization attached

14. Letter of participation The ABC Book Company assist various organizations in literacy projects for elementary school students in need. ABC Book will provide an amount equal to the organizations contribution towards the project. The company will require that its information be included in any distribution and the company’s logo be placed in product delivered. In addition, the company will require that its name be mention in any form of publicity. Best regards Cecil Bookworm Educational advisor to ABC Books

17. Project Budget Items purchased VendorCost 1200 dictionaries @ $2.00 each The Dictionary Project $ 2,400 6 rolls of Rotary labels at $5.00/roll Russell Hampton 30 Total costs $2,430 Funds from District 5790 Club $1,230 Funds requested from District 5790 for District Project Grant 1,200 Funds from other Rotary Club I District outside USA (if applicable) Funds from “Other" sources List all "other" sources of funds TOTAL (Must be equal to budget cost 2,430 What if you are working with a cooperating organization?

18. Project Budget Items purchased VendorCost 2400 dictionaries @ $2.00 each The Dictionary Project 4,800 24 rolls of Rotary labels at $5.00/roll Russell Hampton 120 Total costs4,920 Funds from District 5790 Club 1,920 Funds requested from District 5790 for District Project Grant 1,200 Funds from other Rotary Club I District outside USA (if applicable) Funds from “Other" sources 1,800 List all "other" sources of funds TOTAL (Must be equal to budget cost 4,920

19. 7. DISTRICT GRANTS SUBCOMMITTEE CHAIR CERTIFICATION The district grants subcommittee chair from District 5790 must certify the application as complete. If the application is not complete or eligible, it will be returned to the host partner with a brief explanation. "On behalf of the committee, I hereby certify that to the best of my knowledge and ability this grant application is complete and meets all District 5790 and TRF guidelines." DISTRICT 5790 GRANTS SUBCOMMITTEE CHAIR SIGNATURE _______________________________________Date_________________ _ 8. REPORTS Although both partners are responsible for completing progress and final reports, District 5790 requires that the District 5790 club take primary responsibility for submitting the reports to the District for subsequent reporting to The Rotary Foundation. "By signing below, our club/district accepts primary reporting responsibility." Signature_______ Required _______________________ Date______ Required __________

20. Required Club president ______________________ Club______________________ Signature _________________________ Date_________________________ Club President is the binding representative

21. Record Keeping Invoices required on all purchased items Copy all invoices and organize in easy to follow format List invoices with vendors and amounts on excel spreadsheet to ensure correct balance Submit copies and excel spreadsheet with final report

22. The Final Report Individual Project Report Return this completed form to your District Rotary Foundation Committee Chair. Do not send this form directly to TRF. Rotary Club: __of North Central Texas Area_______ Project Title: Literacy with Dictionaries Progress report ____ Final report Project _X__ Description 1. Describe the project. What was done, when, and where did project activities take place? If this is a progress report, what remains to be done? During the week of September 15 th, 2011, The Rotary Club of NCTA distributed 2400 dictionaries to 3 rd grade students at AAA Elementary School and BBB Elementary School and CCC elementary school and DDD Elementary School. 2. How many people benefited from this project? 2400 students 3. Who were the beneficiaries, how were they impacted by this project, and what humanitarian need was met? Dictionaries are tools for young individuals to understand the English language. Along with adult instruction these 3 rd grade students have increase their vocabulary and they are reading more proficiently. Teachers have reported that students use the dictionaries on a daily basis and that comprehension among students has improved.

23. 4. How many Rotarians participated in the project? 25 Rotarians 5. What did they do? Please give at least two examples, not including financial support provided to the project. Rotarians met with school administrators and teachers and determined the number of dictionaries needed. Rotarians made the purchase of the books and placed labels in all the books Rotarians in teams of five distributed the dictionaries in each of the four schools. A follow up committee met with teachers to determine the results. 6. If a cooperating organization was involved, what was its role? Sponsor organization

24. Financial Report (District must retain receipts of all expenditures for at least five years) Currency Used: Exchange Rate:= 1 USD 7. Income 1. District Simplified Grant funds received from the District 1,200 2. Other Funding (specify) from Rotary Club 1,230 3. Total Project Income 2,430 8. Expenditures (please be specific and add lines as needed) 1. Dictionary Project2,400 2. Russell Hampton 30 Total Project Expenditures 2,430

25. Or if working with a cooperating organization 6. If a cooperating organization was involved, what was its role? ABC Book company matched the club contribution for the dictionaries. The company’s information was included in each dictionary and the company was given recognition in the local paper Financial Report (District must retain receipts of all expenditures for at least five years) Currency Used: Exchange Rate:= 1 USD 7. Income 1. District Simplified Grant funds received from the District 1,200 2. Other Funding (specify) From the Club 1,920 3. ABC Book Company 1,800 Total Project Income 4,920 8. Expenditures (please be specific and add lines as needed) 1. Dictionary Project 4,800 2. Russell Hampton 120 Total Project Expenditures 4,920

26. Certifying Signature By signing this report, I confirm that to the best of my knowledge these District Simplified Grant funds were spent only for eligible items in accordance with Trustee-approved guidelines, and that all of the information contained herein is true and accurate. I also understand that all photographs submitted in connection with this report will become the property of RI and will not be returned. I warrant that I own all rights in the photographs, including copyright, and hereby grant RI and TRF a royalty free irrevocable license to use the photographs now or at any time in the future, throughout the world in any manner it so chooses and in any medium now known or later developed. This includes the right to modify the photograph(s) as necessary in RI’s sole discretion. This also includes, without limitation, use on or in the web sites, magazines, brochures, pamphlets, exhibitions and any other promotional materials of RI and TRF. Certifying Signature Required Date: Required Print name, Rotary title, and club Required

27. Invoice 100A August 15, 2011 The Dictionary Project 1,200 dictionaries at @2.00 each 2,400 Net 30 days

28. Invoice 205B August 15, 2011 Russell Hampton 6 rolls of Rotary labels at @$5.00 each $30 Net 30 days

29. Invoice Summary Report Vendor Invoice # Date Amount Dictionary Project 100A 15-Aug-11 2,400 Russell Hampton 205B 15-Aug-11 30 Total 2,430

30. Checklist __Application completed with all necessary contact information __Application contains all necessary signatures __Letter from cooperating organization include __Project Income equals Project expenditures __Copies of invoices include __Invoice Summary Report include __Copy of check and bank statement indicating that the check has cleared __Final Report signed and dated