Annex A, Operational Forms¶
How to use: These 10 forms are designed to be photocopied and used in the field. Print them BEFORE the disaster. Keep 20 copies of each in your emergency kit. Each form works on paper (by hand) or digitally (fillable PDF).
Table of forms¶
- SITREP, Situation Report
- Rapid Needs Assessment
- Beneficiary Register
- Daily Financial Log
- Volunteer Registration
- Donations and Gifts Tracking
- Press and Social Media Releases
- NGO Partnership Agreement (MOU)
- After-Action Report (AAR)
- Funding Decision Tree
Form 1, SITREP, Situation Report¶
Frequency: Every 6 hours (Phase 1), then daily (Phase 2), then weekly (Phase 3). Filled by: Club Disaster Coordinator or District DRO. Recipients: District (DRO), Zone, DNA-RAG if activated.
SITREP No. _ | Date: /_/_ | Time: :____¶
Club / District: ___________
Report author: ____ Phone: ______
Type of disaster: ______
Activation level: ☐ Club alone ☐ DCA-3 ☐ DCA-2 ☐ DCA-1
Financial recommendation (to be checked by the author): ☐ No external funding needed ☐ District DDRF ☐ DRG to be submitted ☐ Zone Fund ☐ Global Grant to be set up
A, General situation¶
| Element | Data |
|---|---|
| Affected geographic area | __________ |
| Estimated total population affected | __________ |
| Number of confirmed deaths | __________ |
| Number of injured | __________ |
| Number of displaced persons | __________ |
| Number of destroyed homes | __________ |
| Number of damaged homes | __________ |
| Critical infrastructure out of service | __________ |
B, Status of essential services¶
| Service | Functional | Partial | Out of service |
|---|---|---|---|
| Drinking water | ☐ | ☐ | ☐ |
| Electricity | ☐ | ☐ | ☐ |
| Telephone network | ☐ | ☐ | ☐ |
| Main roads | ☐ | ☐ | ☐ |
| Hospital / health center | ☐ | ☐ | ☐ |
| Schools | ☐ | ☐ | ☐ |
| Market / supply | ☐ | ☐ | ☐ |
C, Rotary actions underway¶
| Action | Responsible | No. beneficiaries | Status |
|---|---|---|---|
| ________ | ______ | ___ | ☐ In progress ☐ Completed |
| ________ | ______ | ___ | ☐ In progress ☐ Completed |
| ________ | ______ | ___ | ☐ In progress ☐ Completed |
| ________ | ______ | ___ | ☐ In progress ☐ Completed |
| ________ | ______ | ___ | ☐ In progress ☐ Completed |
| ________ | ______ | ___ | ☐ In progress ☐ Completed |
D, Immediate unmet needs¶
| Priority | Need | Estimated quantity | Urgency |
|---|---|---|---|
| 1 | ________ | ___ | ☐ Critical ☐ Urgent ☐ Moderate |
| 2 | ________ | ___ | ☐ Critical ☐ Urgent ☐ Moderate |
| 3 | ________ | ___ | ☐ Critical ☐ Urgent ☐ Moderate |
| 4 | ________ | ___ | ☐ Critical ☐ Urgent ☐ Moderate |
| 5 | ________ | ___ | ☐ Critical ☐ Urgent ☐ Moderate |
E, Available resources¶
| Resource | Quantity | Source |
|---|---|---|
| Funds available (club/district) | _____ USD | ________ |
| Active volunteers | _____ | ________ |
| Vehicles | _____ | ________ |
| Emergency stocks | _____ | ________ |
F, Next steps (next 6-24 hours)¶
G, Requests to the higher level¶
☐ No request
☐ Activation of higher DCA → justification: _________
☐ DRG request → estimated amount: _____ USD
☐ RAG activation → which one: ____________
☐ Other: ___________
Signature: ____ Date/Time: _____
Form 2, Rapid Needs Assessment¶
When: Within the first 6 hours after the disaster. By whom: Club assessment team (minimum 2 persons). Duration: 1 to 3 hours in the field.
Date: _//_ Start time: _: End time: _:
Assessors: 1. ____ 2. ____
Area assessed: ___________
GPS (if available): Lat: ___ Long: _____
Domain 1, Affected population¶
| Category | Estimated number |
|---|---|
| Affected families | ______ |
| Affected persons (total) | ______ |
| Children (0-5 years) | ______ |
| Children (6-17 years) | ______ |
| Pregnant / breastfeeding women | ______ |
| Elderly (65+) | ______ |
| Persons with disabilities | ______ |
| Deceased persons | ______ |
| Injured persons | ______ |
| Missing persons | ______ |
Domain 2, Housing / shelter¶
| Status | Number of houses |
|---|---|
| Totally destroyed | ______ |
| Partially damaged (habitable) | ______ |
| Partially damaged (uninhabitable) | ______ |
| Intact | ______ |
Emergency housing needed for: ______ families
Potential sites identified: __________
Domain 3, Water and sanitation (WASH)¶
| Element | Yes | No | Partial |
|---|---|---|---|
| Access to drinking water | ☐ | ☐ | ☐ |
| Functional water network | ☐ | ☐ | ☐ |
| Usable latrines / toilets | ☐ | ☐ | ☐ |
| Risk of water contamination | ☐ | ☐ | ☐ |
| Functional waste disposal system | ☐ | ☐ | ☐ |
Liters of drinking water needed / day: ______
Domain 4, Food¶
| Element | Yes | No | Details |
|---|---|---|---|
| Food stocks available in the area | ☐ | ☐ | For ___ days |
| Functional local market | ☐ | ☐ | ______ |
| External supply possible | ☐ | ☐ | ______ |
| Community kitchen possible | ☐ | ☐ | ______ |
Number of meals / day needed: ______
Domain 5, Health¶
| Element | Yes | No | Details |
|---|---|---|---|
| Functional health center nearby | ☐ | ☐ | ______ |
| Medical personnel available | ☐ | ☐ | ______ |
| Medicines available | ☐ | ☐ | ______ |
| Identified epidemic risk | ☐ | ☐ | ______ |
| Women/children requiring urgent care | ☐ | ☐ | No.: _______ |
Domain 6, Infrastructure¶
| Infrastructure | Functional | Damaged | Destroyed |
|---|---|---|---|
| Main road | ☐ | ☐ | ☐ |
| Bridge(s) | ☐ | ☐ | ☐ |
| Electricity | ☐ | ☐ | ☐ |
| Fixed telephone | ☐ | ☐ | ☐ |
| Mobile network | ☐ | ☐ | ☐ |
| Internet | ☐ | ☐ | ☐ |
Domain 7, Access¶
Site access by: ☐ Road ☐ Track ☐ Foot only ☐ Water
Access time from the club: ______ hours
Obstacles identified: ___________
Domain 8, Safety¶
| Element | Yes | No | Details |
|---|---|---|---|
| Area safe for responders | ☐ | ☐ | ______ |
| Secondary risks (aftershocks, floods, landslides) | ☐ | ☐ | ______ |
| Presence of law enforcement | ☐ | ☐ | ______ |
| Reported looting risk | ☐ | ☐ | ______ |
| Safe access for distributions | ☐ | ☐ | ______ |
Immediate priority needs (rank 1 to 10)¶
| Rank | Need |
|---|---|
| ___ | Drinking water |
| ___ | Food |
| ___ | Emergency shelters / tarps |
| ___ | Medical care |
| ___ | Clothing / blankets |
| ___ | Hygiene items |
| ___ | Evacuation |
| ___ | Search and rescue |
| ___ | Psychological support |
| ___ | Other: ________ |
Organizations already present¶
| Organization | Type of aid | Contact |
|---|---|---|
| ________ | ________ | ______ |
| ________ | ________ | ______ |
| ________ | ________ | ______ |
| ________ | ________ | ______ |
Observations and photos¶
Field notes: ___________
Photos taken: ☐ Yes (number: _____) ☐ No
Assessor 1 signature: ___ Date: ______
Assessor 2 signature: ___ Date: ______
Form 3, Beneficiary Register¶
Use: Document each distribution of aid. One form per distribution point per day. Mandatory for TRF stewardship reports.
Distribution header¶
Date: _//_ Distribution location: _______
Type of aid distributed: ____________
Distribution manager: ____ Club: ______
Funding: ☐ Club funds ☐ DRG ☐ DDRF ☐ Global Grant ☐ Direct donations ☐ Other
Beneficiary list¶
| No. | Full name | No. pers. in household | Location / address | Identified needs | Aid received (type + quantity) | Signature or fingerprint |
|---|---|---|---|---|---|---|
| 1 | ______ | _____ | ______ | ______ | ______ | _______ |
| 2 | ______ | _____ | ______ | ______ | ______ | _______ |
| 3 | ______ | _____ | ______ | ______ | ______ | _______ |
| 4 | ______ | _____ | ______ | ______ | ______ | _______ |
| 5 | ______ | _____ | ______ | ______ | ______ | _______ |
| 6 | ______ | _____ | ______ | ______ | ______ | _______ |
| 7 | ______ | _____ | ______ | ______ | ______ | _______ |
| 8 | ______ | _____ | ______ | ______ | ______ | _______ |
| 9 | ______ | _____ | ______ | ______ | ______ | _______ |
| 10 | ______ | _____ | ______ | ______ | ______ | _______ |
| 11 | ______ | _____ | ______ | ______ | ______ | _______ |
| 12 | ______ | _____ | ______ | ______ | ______ | _______ |
| 13 | ______ | _____ | ______ | ______ | ______ | _______ |
| 14 | ______ | _____ | ______ | ______ | ______ | _______ |
| 15 | ______ | _____ | ______ | ______ | ______ | _______ |
| 16 | ______ | _____ | ______ | ______ | ______ | _______ |
| 17 | ______ | _____ | ______ | ______ | ______ | _______ |
| 18 | ______ | _____ | ______ | ______ | ______ | _______ |
| 19 | ______ | _____ | ______ | ______ | ______ | _______ |
| 20 | ______ | _____ | ______ | ______ | ______ | _______ |
| 21 | ______ | _____ | ______ | ______ | ______ | _______ |
| 22 | ______ | _____ | ______ | ______ | ______ | _______ |
| 23 | ______ | _____ | ______ | ______ | ______ | _______ |
| 24 | ______ | _____ | ______ | ______ | ______ | _______ |
| 25 | ______ | _____ | ______ | ______ | ______ | _______ |
Distribution summary¶
| Element | Total |
|---|---|
| Total number of beneficiaries | ______ |
| Total number of households served | ______ |
| Total quantity distributed | ______ |
| Estimated value (USD) | ______ |
| Remaining stock | ______ |
Notes: __________
Manager signature: __ Witness signature: ______
Form 4, Daily Financial Log¶
Use: Dedicated disaster cash log. One form per day. Dual signature mandatory for any expense > 100 USD.
Financial log, Date: _//_¶
Club / District: ____ Treasurer: ______
Dedicated disaster account No.: ________
Opening balance¶
| Source | Amount (USD) |
|---|---|
| Previous day's balance carried over | ____ |
| Allocated club funds | ____ |
| DRG received | ____ |
| DDRF received | ____ |
| Donations received today | ____ |
| TOTAL AVAILABLE | ____ |
Expenses of the day¶
| No. | Description | Supplier | Amount (USD) | Category | Receipt No. | Authorized by |
|---|---|---|---|---|---|---|
| 1 | ________ | ______ | ___ | ______ | _ | ______ |
| 2 | ________ | ______ | ___ | ______ | _ | ______ |
| 3 | ________ | ______ | ___ | ______ | _ | ______ |
| 4 | ________ | ______ | ___ | ______ | _ | ______ |
| 5 | ________ | ______ | ___ | ______ | _ | ______ |
| 6 | ________ | ______ | ___ | ______ | _ | ______ |
| 7 | ________ | ______ | ___ | ______ | _ | ______ |
| 8 | ________ | ______ | ___ | ______ | _ | ______ |
| 9 | ________ | ______ | ___ | ______ | _ | ______ |
| 10 | ________ | ______ | ___ | ______ | _ | ______ |
| TOTAL EXPENSES | ___ |
Categories: A = Food/water | B = Shelters/materials | C = Transport/logistics | D = Health/hygiene | E = Communication | F = Administration | G = Other
Closing balance¶
| Calculation | Amount (USD) |
|---|---|
| Total available | ____ |
| - Total expenses | ____ |
| = Closing balance | ____ |
Cumulative balance since the start of the operation: ____ USD
Supporting documents¶
| Type | Quantity |
|---|---|
| Receipts / invoices attached | ______ |
| Purchase orders | ______ |
| Photos of receipts (if originals lost) | ______ |
Treasurer signature: ____ President signature: _______
Form 5, Volunteer Registration¶
Use: Register each volunteer BEFORE deployment. Verify skills, availability and health status. Keep this register for insurance and follow-up.
Volunteer registration form¶
Registration date: _//_ Club: _______
Identity¶
| Field | Information |
|---|---|
| Full name | _______ |
| Date of birth | _//_ |
| Primary phone | _______ |
| Secondary phone | _______ |
| _______ | |
| Address | _______ |
| Emergency contact (name + phone) | _______ |
| Rotary member | ☐ Yes (Club: ______) ☐ No |
| Rotaract / Interact | ☐ Yes ☐ No |
Skills¶
| Skill | Yes | Level | Certification |
|---|---|---|---|
| First aid / basic CPR | ☐ | ☐ Basic ☐ Advanced | Date: ____ |
| Psychological support (PFA) | ☐ | ☐ Basic ☐ Advanced | Date: ____ |
| Medical (nurse, doctor) | ☐ | Specialty: ____ | No.: ____ |
| Construction / repair | ☐ | ☐ Basic ☐ Advanced | _____ |
| Electricity / plumbing | ☐ | ☐ Basic ☐ Advanced | _____ |
| Heavy vehicle driving | ☐ | License: ____ | _____ |
| Communication / media | ☐ | ☐ Basic ☐ Advanced | _____ |
| Logistics / stock management | ☐ | ☐ Basic ☐ Advanced | _____ |
| Community cooking | ☐ | ☐ Basic ☐ Advanced | _____ |
| Translation (languages: ___) | ☐ | ______ | _____ |
| Other: ________ | ☐ | ______ | _____ |
Availability and assignment¶
| Day | Available | Hours | Assignment / area |
|---|---|---|---|
| Monday | ☐ | _: to _: | ______ |
| Tuesday | ☐ | _: to _: | ______ |
| Wednesday | ☐ | _: to _: | ______ |
| Thursday | ☐ | _: to _: | ______ |
| Friday | ☐ | _: to _: | ______ |
| Saturday | ☐ | _: to _: | ______ |
| Sunday | ☐ | _: to _: | ______ |
Possible commitment duration: ☐ 1-3 days ☐ 1 week ☐ 2 weeks ☐ 1 month+
Mobility: ☐ Personal vehicle ☐ Public transport ☐ Transport needed
Health and safety¶
| Element | Response |
|---|---|
| Medical restrictions | ☐ No ☐ Yes: _________ |
| Allergies | ☐ No ☐ Yes: _________ |
| Vaccinations up to date | ☐ Yes ☐ No ☐ Don't know |
| Personal insurance covering volunteering | ☐ Yes ☐ No |
Field check-in/out¶
| Date | Arrival time (check-in) | Departure time (check-out) | Area / mission | Manager signature |
|---|---|---|---|---|
| ____ | _:_ | _:_ | ______ | _____ |
| ____ | _:_ | _:_ | ______ | _____ |
| ____ | _:_ | _:_ | ______ | _____ |
| ____ | _:_ | _:_ | ______ | _____ |
| ____ | _:_ | _:_ | ______ | _____ |
| ____ | _:_ | _:_ | ______ | _____ |
| ____ | _:_ | _:_ | ______ | _____ |
Commitment¶
I commit to: - [ ] Respect safety instructions - [ ] Follow the coordinator's instructions - [ ] Not communicate with the media without authorization - [ ] Report any incident or injury immediately - [ ] Respect the dignity of persons helped
Signature: ____ Date: _/_/_____
Consolidated volunteer register (summary table)¶
| No. | Name | Primary skill | Phone | Availability | Deployed on | Area | Check-out |
|---|---|---|---|---|---|---|---|
| 1 | ______ | ____ | ____ | ___ | ___ | _ | _ |
| 2 | ______ | ____ | ____ | ___ | ___ | _ | _ |
| 3 | ______ | ____ | ____ | ___ | ___ | _ | _ |
| 4 | ______ | ____ | ____ | ___ | ___ | _ | _ |
| 5 | ______ | ____ | ____ | ___ | ___ | _ | _ |
| 6 | ______ | ____ | ____ | ___ | ___ | _ | _ |
| 7 | ______ | ____ | ____ | ___ | ___ | _ | _ |
| 8 | ______ | ____ | ____ | ___ | ___ | _ | _ |
| 9 | ______ | ____ | ____ | ___ | ___ | _ | _ |
| 10 | ______ | ____ | ____ | ___ | ___ | _ | _ |
| 11 | ______ | ____ | ____ | ___ | ___ | _ | _ |
| 12 | ______ | ____ | ____ | ___ | ___ | _ | _ |
| 13 | ______ | ____ | ____ | ___ | ___ | _ | _ |
| 14 | ______ | ____ | ____ | ___ | ___ | _ | _ |
| 15 | ______ | ____ | ____ | ___ | ___ | _ | _ |
| 16 | ______ | ____ | ____ | ___ | ___ | _ | _ |
| 17 | ______ | ____ | ____ | ___ | ___ | _ | _ |
| 18 | ______ | ____ | ____ | ___ | ___ | _ | _ |
| 19 | ______ | ____ | ____ | ___ | ___ | _ | _ |
| 20 | ______ | ____ | ____ | ___ | ___ | _ | _ |
Form 6, Donations and Gifts Tracking¶
Use: Track every donation received. Mandatory for transparency, tax receipts and thank-you letters. One form per week or per campaign.
Donation register, Operation: _______¶
Club / District: ____ Period: from /_ to /____
Tracking manager: ____ Phone: ______
| No. | Donor (name or organization) | Amount / Description | Date | Reception method | Allocation / purpose | Tax receipt issued | Thanks sent |
|---|---|---|---|---|---|---|---|
| 1 | ________ | ____ | __ | ☐ Transfer ☐ Check ☐ Cash ☐ In kind | ____ | ☐ | ☐ |
| 2 | ________ | ____ | __ | ☐ Transfer ☐ Check ☐ Cash ☐ In kind | ____ | ☐ | ☐ |
| 3 | ________ | ____ | __ | ☐ Transfer ☐ Check ☐ Cash ☐ In kind | ____ | ☐ | ☐ |
| 4 | ________ | ____ | __ | ☐ Transfer ☐ Check ☐ Cash ☐ In kind | ____ | ☐ | ☐ |
| 5 | ________ | ____ | __ | ☐ Transfer ☐ Check ☐ Cash ☐ In kind | ____ | ☐ | ☐ |
| 6 | ________ | ____ | __ | ☐ Transfer ☐ Check ☐ Cash ☐ In kind | ____ | ☐ | ☐ |
| 7 | ________ | ____ | __ | ☐ Transfer ☐ Check ☐ Cash ☐ In kind | ____ | ☐ | ☐ |
| 8 | ________ | ____ | __ | ☐ Transfer ☐ Check ☐ Cash ☐ In kind | ____ | ☐ | ☐ |
| 9 | ________ | ____ | __ | ☐ Transfer ☐ Check ☐ Cash ☐ In kind | ____ | ☐ | ☐ |
| 10 | ________ | ____ | __ | ☐ Transfer ☐ Check ☐ Cash ☐ In kind | ____ | ☐ | ☐ |
| 11 | ________ | ____ | __ | ☐ Transfer ☐ Check ☐ Cash ☐ In kind | ____ | ☐ | ☐ |
| 12 | ________ | ____ | __ | ☐ Transfer ☐ Check ☐ Cash ☐ In kind | ____ | ☐ | ☐ |
| 13 | ________ | ____ | __ | ☐ Transfer ☐ Check ☐ Cash ☐ In kind | ____ | ☐ | ☐ |
| 14 | ________ | ____ | __ | ☐ Transfer ☐ Check ☐ Cash ☐ In kind | ____ | ☐ | ☐ |
| 15 | ________ | ____ | __ | ☐ Transfer ☐ Check ☐ Cash ☐ In kind | ____ | ☐ | ☐ |
Totals¶
| Category | Total |
|---|---|
| Total monetary donations (USD) | ____ |
| Total in-kind donations (estimated value USD) | ____ |
| Grand total | ____ |
| Number of tax receipts issued | ____ |
| Number of thanks sent | ____ |
Form 7, Press and Social Media Releases¶
Golden rule: ONE designated spokesperson. Every release validated by the President or DG before publication.
7.1 Press release template¶
PRESS RELEASE
[Rotary Logo]
For immediate release
Date: ____/____/________
Press contact:
Name: ________________________________
Phone: ________________________________
Email: ________________________________
------------------------------------------------------
[HEADLINE — Clear action, 10 words maximum]
Example: Rotary Club of [city] mobilizes [X] volunteers
after [type of disaster]
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[City], [date] — The Rotary Club of [name] / District
[number] of Rotary mobilizes following [brief description
of the disaster] which affected [area] on [date].
PARAGRAPH 1 — The facts:
[Describe the situation: number of people affected, damage,
context]
PARAGRAPH 2 — Rotary's action:
[Concretely describe what Rotary is doing: number of
volunteers, type of aid, amounts committed, partnerships]
PARAGRAPH 3 — Quote:
"[Quote from Club President or District Governor],"
says [Name], [Title].
PARAGRAPH 4 — How to help:
Those wishing to contribute can:
- Make a donation: [link or bank details]
- Volunteer: [contact]
- Follow developments: [Facebook page / website]
PARAGRAPH 5 — About Rotary:
Rotary brings together [X] members in [X] clubs across
the world. [1-2 sentences on the Rotary mission and disaster
response].
------------------------------------------------------
END OF RELEASE
High-resolution photos available on request.
7.2 Social media templates¶
Initial post (0-6 hours)¶
ALERT — [Type of disaster] in [location]
The Rotary Club of [name] is activating its emergency response.
Our teams are in the field to assess needs
and provide first aid.
More information to follow.
#Rotary #[City] #DisasterResponse #PeopleOfAction
Mobilization post (6-24 hours)¶
UPDATE — Response to [disaster] in [location]
Our teams have already:
- [Action 1 — e.g., distributed 200 hygiene kits]
- [Action 2 — e.g., opened 2 shelter centers]
- [Action 3 — e.g., mobilized 45 volunteers]
[X] families have received emergency aid.
To help financially: [donation link]
To volunteer: [contact]
#Rotary #PeopleOfAction #DisasterRelief
Thank-you post (after operation)¶
THANK YOU — Summary of our response to [disaster]
In [X] days, thanks to YOU:
- [X] families helped
- [X] volunteers mobilized
- [X] USD collected and distributed
- [X] kits distributed
Thanks to our partners: [list]
Thanks to all donors and volunteers.
Rotary continues to support the reconstruction.
#Rotary #PeopleOfAction #ThankYou
Form 8, NGO Partnership Agreement (MOU)¶
Use: Formalize any partnership with an NGO that exceeds 2 weeks or 5,000 USD. Mandatory for Global Grants.
PARTNERSHIP AGREEMENT
FOR DISASTER RESPONSE
------------------------------------------------------
BETWEEN:
The [Rotary Club of _________ / District _________ of Rotary]
Represented by: _________________________________________
Position: _______________________________________________
Address: ________________________________________________
Phone: __________________ Email: __________________________
Hereinafter referred to as "Rotary"
AND:
[Name of NGO / Partner organization]
Represented by: _________________________________________
Position: _______________________________________________
Address: ________________________________________________
Phone: __________________ Email: __________________________
Hereinafter referred to as "the Partner"
------------------------------------------------------
ARTICLE 1 — PURPOSE
This agreement defines the terms of collaboration
between Rotary and the Partner for the response to:
Type of disaster: ____________________________________
Geographic area: ______________________________________
Target population: ________________________________________
Start date: ____/____/________
Expected duration: ___________________________________________
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ARTICLE 2 — ROTARY COMMITMENTS
Rotary commits to:
☐ Provide funding of ____________ USD
☐ Mobilize ____________ volunteers
☐ Provide equipment: ___________________________________
☐ Ensure coordination with District / Zone
☐ Produce stewardship reports required by TRF
☐ Other: _________________________________________________
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ARTICLE 3 — PARTNER COMMITMENTS
The Partner commits to:
☐ Deploy ____________ qualified personnel
☐ Provide technical expertise in: _________________________
☐ Ensure logistics of: ________________________________
☐ Provide activity reports: ☐ Weekly ☐ Monthly
☐ Respect humanitarian standards (Sphere, CHS)
☐ Mention Rotary in its communications
☐ Provide financial supporting documents
☐ Other: _________________________________________________
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ARTICLE 4 — BUDGET AND FINANCING
Total operation budget: ____________ USD
| Line item | Rotary (USD) | Partner (USD) | Other (USD) |
|---|---|---|---|
| Personnel | ____ | ____ | ____ |
| Material / equipment | ____ | ____ | ____ |
| Transport / logistics | ____ | ____ | ____ |
| Food / water | ____ | ____ | ____ |
| Housing | ____ | ____ | ____ |
| Administration | ____ | ____ | ____ |
| Other | ____ | ____ | ____ |
| TOTAL | ____ | ____ | ____ |
Payment terms:
☐ In one payment upon signing
☐ In _____ installments: _____________________________________
☐ Upon presentation of invoices
☐ Other: _________________________________________________
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ARTICLE 5 — COORDINATION
Coordination meetings: ☐ Daily ☐ Weekly
☐ Bi-monthly
Rotary focal point: _________________ Phone: _________________
Partner focal point: ______________ Phone: _________________
Progress reports: ☐ Weekly ☐ Monthly
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ARTICLE 6 — COMMUNICATION AND VISIBILITY
- All public communication mentions both parties.
- The Rotary logo is used in accordance with the RI brand guide.
- The Partner does not solicit donations on behalf of Rotary.
- Photos of beneficiaries respect their dignity and
consent.
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ARTICLE 7 — DURATION AND TERMINATION
Duration: from ____/____/________ to ____/____/________
Renewal: ☐ Automatic ☐ By mutual agreement ☐ No
Early termination: possible by each party with
_______ days' notice, by written notification.
In case of termination, the Partner returns unused
funds within _______ days.
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ARTICLE 8 — REPORTS AND STEWARDSHIP
The Partner provides Rotary with:
☐ Interim report no later than ____/____/________
☐ Final report no later than ____/____/________
☐ Supporting documents (receipts, invoices, photos)
☐ Beneficiary list (anonymized if necessary)
☐ Impact evaluation
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ARTICLE 9 — DISPUTES
Any dispute will be resolved by amicable conciliation.
Failing this, the competent courts of __________________
will be seized.
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Made in two copies in ________________, on ____/____/________
For Rotary: For the Partner:
Name: ____________________ Name: ____________________
Position: ________________ Position: ________________
Signature: Signature:
Witness: Witness:
Name: ____________________ Name: ____________________
Signature: Signature:
Form 9, After-Action Report (AAR)¶
Use: Structured debriefing meeting after each operation. Mandatory. Recommended duration: 2-3 hours. All participants invited.
After-Action Report, Operation: _________¶
AAR date: _//_
Facilitator: ____ Secretary: ____
Participants:
| No. | Name | Role in the operation |
|---|---|---|
| 1 | ________ | ________ |
| 2 | ________ | ________ |
| 3 | ________ | ________ |
| 4 | ________ | ________ |
| 5 | ________ | ________ |
| 6 | ________ | ________ |
| 7 | ________ | ________ |
| 8 | ________ | ________ |
Section A, Operation timeline¶
| Date/Time | Event / Decision | By whom |
|---|---|---|
| ____ | _______ | ______ |
| ____ | _______ | ______ |
| ____ | _______ | ______ |
| ____ | _______ | ______ |
| ____ | _______ | ______ |
| ____ | _______ | ______ |
| ____ | _______ | ______ |
| ____ | _______ | ______ |
| ____ | _______ | ______ |
| ____ | _______ | ______ |
Section B, Operation summary¶
| Element | Detail |
|---|---|
| Type of disaster | _______ |
| Disaster date | _//_ |
| Rotary activation date | _//_ |
| Closure date | _//_ |
| Total operation duration | _ days |
| Geographic area | _______ |
| Activation level | ☐ Club ☐ DCA-3 ☐ DCA-2 ☐ DCA-1 |
Section C, Results¶
| Indicator | Initial target | Actual result |
|---|---|---|
| People helped | ______ | ______ |
| Households served | ______ | ______ |
| Volunteers mobilized | ______ | ______ |
| Volunteer hours | ______ | ______ |
| Total budget spent (USD) | ______ | ______ |
| Kits distributed | ______ | ______ |
| Meals served | ______ | ______ |
| Shelters provided | ______ | ______ |
Section D, Funding¶
| Source | Amount received (USD) | Amount spent (USD) | Balance (USD) |
|---|---|---|---|
| Club funds | ______ | ______ | ______ |
| DRG | ______ | ______ | ______ |
| DDRF | ______ | ______ | ______ |
| Global Grant | ______ | ______ | ______ |
| Direct donations | ______ | ______ | ______ |
| Zone Fund | ______ | ______ | ______ |
| Other | ______ | ______ | ______ |
| TOTAL | ______ | ______ | ______ |
Section E, What worked well¶
| No. | Element | Detail / Example |
|---|---|---|
| 1 | ________ | _______ |
| 2 | ________ | _______ |
| 3 | ________ | _______ |
| 4 | ________ | _______ |
| 5 | ________ | _______ |
Section F, What did not work / needs improvement¶
| No. | Problem identified | Impact | Recommended corrective action | Responsible |
|---|---|---|---|---|
| 1 | ______ | ☐ Critical ☐ Moderate ☐ Minor | ______ | ____ |
| 2 | ______ | ☐ Critical ☐ Moderate ☐ Minor | ______ | ____ |
| 3 | ______ | ☐ Critical ☐ Moderate ☐ Minor | ______ | ____ |
| 4 | ______ | ☐ Critical ☐ Moderate ☐ Minor | ______ | ____ |
| 5 | ______ | ☐ Critical ☐ Moderate ☐ Minor | ______ | ____ |
Section G, Recommendations¶
| No. | Recommendation | Priority | Deadline | Responsible |
|---|---|---|---|---|
| 1 | _________ | ☐ High ☐ Medium ☐ Low | ____ | ____ |
| 2 | _________ | ☐ High ☐ Medium ☐ Low | ____ | ____ |
| 3 | _________ | ☐ High ☐ Medium ☐ Low | ____ | ____ |
| 4 | _________ | ☐ High ☐ Medium ☐ Low | ____ | ____ |
| 5 | _________ | ☐ High ☐ Medium ☐ Low | ____ | ____ |
Section H, Post-operation psychological support¶
| Element | Yes | No | Details |
|---|---|---|---|
| Signs of stress / fatigue identified in volunteers | ☐ | ☐ | _____ |
| Psychological debriefing organized | ☐ | ☐ | Date: ____ |
| Referral to professional support if necessary | ☐ | ☐ | _____ |
| 1-month follow-up planned | ☐ | ☐ | Date: ____ |
This report will be archived and transmitted to: - [ ] District (DRO) - [ ] Zone (if DCA-2/3) - [ ] DNA-RAG (if activated) - [ ] TRF (with stewardship report)
Facilitator signature: ___ Date: _//__
Form 10, Funding Decision Tree¶
Use: When a disaster occurs, follow this tree to determine which funding mechanism to activate, in what order.
DISASTER OCCURS
|
v
Does the Club have own funds available?
|-- YES --> Use immediately (no approval needed)
| Recommended max budget: 2,000-5,000 USD
| |
| v
| Sufficient?
| |-- YES --> Continue with club funds + move to AAR
| '-- NO --> v
|
'-- NO --> v
Does the District have a DDRF (District Disaster Relief Fund)?
|-- YES --> The DG authorizes an immediate disbursement
| Typical amount: 5,000-15,000 USD
| Lead time: a few hours
| |
| v
| Sufficient?
| |-- YES --> Continue + report to District
| '-- NO --> v
|
'-- NO --> v
Request a DRG (Disaster Response Grant) from TRF
|-- Amount: up to 25,000 USD
|-- Condition: District qualified by TRF
|-- Approval lead time: 2-4 weeks (24-48 h pre-impact for named storms)
|-- Submission via MyRotary (DG + DRFC)
| |
| v
| Sufficient?
| |-- YES --> Execute + stewardship report within 12 months
| '-- NO --> v
|
v
Does the Zone have a Zone Disaster Response Fund?
|-- YES --> Request a supplement from the Zone
| Typical amount: 10,000-50,000 USD
| |
| v
| Sufficient?
| |-- YES --> Execute + report to Zone
| '-- NO --> v
|
'-- NO --> v
Set up a TRF Global Grant
|-- Amount: 30,000 to 400,000 USD
|-- Requires: District DDF + international partner
|-- Lead time: 3-6 months (planning to recovery)
|-- Ideal for: reconstruction, WASH, training
|
v
Can they be combined?
|-- YES — Mechanisms are COMBINABLE:
| |-- DRG + DDRF + Club funds = immediate response
| |-- Global Grant = medium-term recovery
| |-- Zone Fund = multi-district coordination
| '-- DNA-RAG Fund = technical expertise
|
v
WARNING — Non-combination rules:
|-- A DRG does NOT fund the same expenses as a Global Grant
|-- DDF used for a Global Grant cannot be used for a DRG
|-- Club funds do NOT require TRF stewardship
'-- Any TRF funding (DRG + Global Grant) requires a report
Mechanism summary table¶
| Mechanism | Amount | Lead time | Who decides | Stewardship |
|---|---|---|---|---|
| Club funds | 1,000-5,000 USD | Immediate | President | No (internal) |
| DDRF | 5,000-15,000 USD | Hours | DG | District report |
| DRG | Up to 25,000 USD | 2-4 weeks (24-48 h pre-impact) | TRF | Yes (12 months) |
| Zone Fund | 10,000-50,000 USD | Days | Zone Director | Zone report |
| Global Grant | 30,000-400,000 USD | 3-6 months | TRF | Yes (mandatory) |
| DNA-RAG Fund | Variable | Days | DNA-RAG Chair | RAG report |
| TRF Central Fund | Variable | Weeks | TRF Trustees | Yes |
Quick reference, which funding at which moment¶
This quick reference condenses the full decision tree into a single sheet, to be photocopied and slipped into the club's emergency kit. It answers one operational question: at H+12, at D+5, at D+30, at M+6, which of the seven mechanisms should be activated?
By response phase¶
| Phase | Time since event | Mechanisms to activate | Club's immediate action |
|---|---|---|---|
| Immediate emergency | 0–72 h | Club funds + DDRF + DRG (in preparation) | Engage initial spending from own funds. Ask the DG to activate the DDRF. Prepare the field assessment for the DRG. |
| Stabilization | 1–4 weeks | Approved DRG + Zone Fund + DNA-RAG Fund | Launch community kitchen, structured distributions, volunteer rotations. Document each expense for the preliminary DRG report (D+45). |
| Short-term recovery | 1–6 months | DRG balance + Global Grant under preparation + NGO partnerships | Identify lasting needs (water, schools, health). Find the international partner club via Club Finder or DNA-RAG. |
| Reconstruction | 6–24 months | Global Grant + Packaged Grants + TRF Central Fund | Steer the project over time. Interim report at M+6, final report at closure. |
By type of emergency¶
| Typical situation | First reflex | Central mechanism | Why |
|---|---|---|---|
| Localized disaster, club acting alone | Own funds + extraordinary dues | Club funds | DCA-3, no district escalation required |
| Regional disaster, several clubs affected | DDRF activation by the DG | DDRF + DRG | DCA-2, the district coordinates |
| Major disaster, several districts | DG + RI + DNA-RAG in coordination | DRG + DNA-RAG Fund + Zone Fund | DCA-1, international mobilization |
| Named cyclone approaching | Preemptive DRG submission | DRG (24-48 h pre-impact) | The only case where the DRG is processed in hours, not weeks |
| Post-disaster reconstruction | Global Grant assembly at D+30 | Global Grant | The DRG is over, time for the long term |
Three rules never to forget¶
- The DDRF is immediate, the DRG takes weeks. Do not wait for the DRG to engage initial spending. The DDRF, club funds and spontaneous donations cover the first 72 hours.
- The preliminary report at D+45 conditions everything that follows. Without this report, the DRG balance is frozen and the district's TRF qualification is called into question. Not one club, not one district: the entire network of your district loses access to grants.
- The DRG does not fund direct cash to victims. Water, shelter, kits, food: yes. Cash: no, except in exceptional approved cases. This is the most frequent trap in the first hours, when a generous Rotarian is tempted to hand out banknotes.
Contacts to keep at hand¶
| Who | Why | When |
|---|---|---|
| DG (district governor) | Activates the DCA and releases the DDRF | H+0 to H+6 |
| DRO (district disaster response officer) | Operational coordination between clubs | H+0 to D+30 |
| DRFC (district foundation chair) | Submits the DRG and co-signs the Global Grant | D+1 to D+10 |
| DNA-RAG zone representative | Technical expertise and international coordination | DCA-2 and DCA-1 |
| Local ShelterBox lead | If emergency shelters are required | DCA-2 and DCA-1 |
Tip. Print these three tables and paste them into the inside cover of the club's emergency kit. At H+0, this is the page the Disaster Coordinator opens first.
Annex A, Operational Forms, Rotary Club Disaster Response Book