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REQUEST FOR PUBLIC FUNDING <br />Non-profit agencies requesting funding from the City of Paris for projects that benefit the citizens of Paris must complete <br />the following information to be eligible for consideration (you may use additional pages, if necessary). In addition, please <br />submit with this form a copy of your agency's most recent financial statement or audit and a detailed budget for the <br />project. Agencies must also make a brief presentation on their pro. ect at a city council meeting. <br />~ <br />Agency Name• Date• <br />Agency Mailing Address: L.~ C~~ ~ c-~ ~ ~ ~~G • ~ ~ <br />g y ~,'r- Agency Fax Number: <br />A enc Phone Number: ' <br />Contact Person: ` c-~, Contact's Title: 2s&S: c,~ <br />Contact's Mailing Address: ~ c- v- - <br />Contact's Phone Number•~~~ Cantact's Fax Number: <br />Contact's Email Address: <br />- <br />, _ <br />- <br />Name of Project:~- ; <br />Location/Service Area of Project: <br />Summary of Project: C~_ <br />1 LQ ~ <br />Describe how your project will benefit the City of Paris and its <br />-77-:> . . / i- ~ ~ \ 11, , , _ , X. i• <br /> <br />c~, <br /> <br /> <br />Is a detailed p <br />~ L~ <br />L:+c;, <br />~ <br />matching funds, attached? ❑ Yes v No <br />Is the agency's most recent financial statement or audit attached`! ~Yes ❑ No i' <br />Have you received funding from the City of Paris in the last five years for this or any other project? Yes ❑ No <br />, <br />If you have received previous city funding, list the name of the proj~the amount of the City's award, and the <br />year awarded: <br />City of Paris 53 Revised 6/10/08 <br /> <br />- ; ~ <br />- ~ ~ - <br />~ <br />List other sources of' fund~ng for this project anc~ the amouuts:%~ c; V!~~ <br />