Apply for Assistance

Disaster Assistance Fund Request

Submitted by Name of Kiwanis Club(Required)

EIN(Required)

Club President(Required)

Club President Email(Required)

Contact Name(Required)

First Last

Contact Email(Required)

Club Mailing Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Phone(Required)

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One sentence summary with the purpose of your request.(Required)

Full description (i.e., who, what, when, where, and why) and its benefit to the community.(Required)

Total Project Cost(Required)

Club's cash contribution to the project(Required)

Assistance Amount Requested (Assistance is limited to the amount available in the Disaster Assistance Fund.)(Required)

Date Funds Needed(Required)

Attach Project budget and/or a quote or estimate of the disaster assistance funds requested. Include funds from the club and others, and "in-kind" donations. Identify sources and amounts of other funding such as grants and other financial contributions. "In-kind" donations include materials, non-club labor, and discounted merchandise.(Required)

Drop files here or

Max. file size: 100 MB.

Attach any supporting documents which support the need for the project (optional).

Max. file size: 100 MB.

Kids Need Kiwanis

Apply for Assistance

Disaster Assistance Fund Request

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