The American Women's Club Of The Hague

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The American Women's Club Of The Hague

The American Women’s Club of The HagueNieuwe Duinweg 25; 2587 AB Den Haag; NederlandsPhone: 070 350 60 07; Fax: 070 358 77 72ABN-AMRO 51.99.10.206AWC PHILANTHROPY: FUNDING APPLICATIONPlease type or write in block, capital letters. Return the completed form to the address above, attention:Philanthropy Chair, at least 6 (six) weeks before the date that you require the funds.A. YOUR ORGANIZATIONNAME OF THE CHARITY / ORGANIZATION:_________________________________________________________________________ADDRESS:_________________________________________________________________________TELEPHONE: ___________________________ FAX: _____________________________WEBSITE: _______________________________________________________________NAME OF CONTACT PERSON: ______________________________________________TITLE: _________________ CONTACT PERSON’S PHONE #: _____________________EMAIL: __________________________________________________________________B. YOUR PROPOSED PROJECTDESCRIBE THE TOTAL PROJECT (feel free to include photographs, brochures, etc.):____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________LIST EQUIPMENT AND MATERIAL YOU ARE ASKING FOR, IF ANY. PLEASE INCLUDECORESPONDING COSTS (use additional sheet of paper if necessary):___________________________________________________________________________________________________________________________________________________________________________________________________________________________HAS THE AWC FUNDED YOUR ORGANIZATION IN THE PAST? ___________________IF SO, PLEASE GIVE APPROXIMATE DATE AND AMOUNT:_________________________________________________________________________WHAT OTHER SOURES OF FUNDING ARE AVAILABLE FOR THIS PROJECT?___________________________________________________________________________________________________________________________________________________________________________________________________________________________


C. GENERAL QUESTIONSAIMS AND OBJECTIVES OF THE ORGANIZATION (you may attach brochures, ads, etc.):____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________WHEN WAS YOUR ORGANZIATION FOUNDED? ________________________________TOTAL NUMBER OF EMPLOYEES: _________________________ON SALARY: _________________ NUMBER OF VOLUNTEERS: _________________________COUNTRY WHERE PROPOSED PROJECT TAKES PLACE: _______________________COUNTRY WHERE INTERNATIONAL HEADQUARTERS ARE LOCATED:_________________________________________________________________________ORGANIZATION’S ANNUAL BUDGET, IN EUROS: _______________________________PRECENT ADMINISTRATIVE: ________________ PERCENT PROJECTS: ___________________WHAT ARE YOUR REGULAR SOURCES OF INCOME? (please indicate by percent)PRIVATE__________%SELF - GENERATED (fundraising, membership fees, etc.)__________%GOVERNMENT SUPPORT__________%RED CROSS__________%UN ORGANZATION (name) _____________________________ __________%OTHER__________%TOTAL: 100 %BRIEFLY DESCRIBE TWO OF YOUR MOST RECENT PROJECTS:1. _________________________________________________________________________________________________________________________________________________________________________________________________________________________2. _________________________________________________________________________________________________________________________________________________________________________________________________________________________DO YOU NEED VOLUNTEERS? ____________ IF SO, HOW MANY? ________________PLEASE DESCRIBE THE VOLUNTEER WORK REQUIRED:_____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________AWC Philanthropy 2011

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