Application for Grant – Club

To be submitted to the Business Manager prior to April 15th to cover
Grant Period August 01 – July 31. Applicant must be a member of the SSRDF Inc.

Zone # ______                            Date ____________________________________              

Name of organization applying: ______________________________________________________________

Name of individual applying: ________________________________________________________________

Address: ______________________________________  City/Town: ________________________________

PC: ___________________Telephone: ________________________

Signature _______________________________________________

Type of Event: ___________________________________________________________________________

Location of Event _______________________________  Date of event  _________________________

Name & Address of caller/cuer/instructor for event _____________________________________________



Estimated number of people attending _______     Charge per person___________________

Estimated Expenses:

Instructor                    $____________________                 Facility                 $__________________

Expenses, travel, etc.  $____________________                Miscellaneous    $__________________

Promotion                   $ ___________________                  

Other (specify) ___________________________                                                $__________________

____________________________________________                                              $__________________

Total estimated expenses                                                                           $__________________

AMOUNT OF GRANT REQUEST                                                                  $_______________
Please include with this application any notices/advertisements/posters/registration forms. The Lottery logo should be on all advertising.

Mail to:   Donna Gruell, Business Manager
163 Church Drive, Regina, SK S4X 1L8
OR          Email:

                 SKlottery logo

Click on each heading below for a printable form or to down load:

Application form

Follow up report

Attendance Report Form