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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 project at a city council meeting. <br />Agency Name• e Date: 4 c <br />Agency Mailing Address: • 0 • P-nyl I d <br />Agency Phone Number:,(qD3)M"25V) Agency Fax Number: (q03) T-6q'2 <br />Contact Person: <br />Contact's Title: <br />Contact's Mailing Address:scaY1 c K5 k ov e, <br />Contact's Phone Number:0--~aXY, 'e, Contact's Fax Number: 'Sa'rt <br />Contact's Email Address: l c h rce ~ su~ er1% 4VYw t 1•con <br />Name of Project•MealS Otn Ur 1-e_el 5 <br />Location/Service <br />Summary of Proj <br />Describe how your project will benefit the Cit of Paris a its citizens: <br />List other sources of funding for this project and t e amounts: <br />S6e t~c~cLq Qc <br />Is a detailed project budget, inc ding columns and descriptions for allocations of city funding and the agency's <br />matching funds, attached? Yes ❑ No <br />Is the agency's most recent financial statement or audit attached? El-Y'es ❑ No <br />Have you received funding from the City of Paris in the last five years for this or any other project?iYes ❑ No <br />If you have received previous city funding, list the name of the project, the amount of the City's award, and the <br />year awarded: <br />« <br />City of Paris Revised 6/10/08 <br />• 000122 <br />