Laserfiche WebLink
REQUEST FOR PUBLIC FUNDING „ <br />Non-profit agencies requesting funding from the City of Paris for projects that benefit the citizefi f P'a-1s 'complete <br />the following information to be eligible for consideration (you may use additional pages, if ne Jf-n , lease <br />iER' <br />submit with this form a copy of your agency's most recent financial statement or audit an~lpef for the <br />project. Agencies must also make a brief presentation on their project at a city council meeting. <br />Agency Name: L r~t- _~o /L <br />Agency Mailing Address: <br />191~ <br />a <br />Agency Phone Number: r~ 3~) -'43 ~,b Agency Fax Number: ~C7 S' 13 q371p <br />Contact Person: f0 tJ ~Zl.t.V4l►~1eSContact's Title: C~(> <br />Contact's Mailing Address: me <br />Contact's Phone Number: m'E' Contact's Fax Number: <br />Contact's Email Address: <br />Name of Project: <br />Location/Service Area of Project:___ m2.r- ~_b Lk <br />Total Project Budget: Total Amount Requested from City: a a~ <br />Number of Beneficiaries: (Sa$t~iFnmary of Project: (2&Lk CZ,}P C (,i ~t7 <br />~ uSP, nA. rrJ% <br />e)~c~ e_ N &-Lk a4,. ~ ri. r1 <br />your project will benefit the City of Paris and its citizens: <br />Z.K ( ,-J <br />L <br />Is a detailed project b <br />including columns and descriptions for allocations of city funding and the agency's <br />Is the agency's most recent financial statement or audit attached? Yes ❑ No <br />Have you received funding from the City of Paris in the last five years for this or any other project?0Yes ❑ No <br />If you have received previous funding from the City, list the name of the project, the amount of the City's award, <br />and the year awarded: l ~ ~ n /uQ 4iyy~,e oA(` cz o- <br />- _ - 78 <br />matching funds, attached? gYes ❑ No <br />City of Paris Revised 7/07/09 <br />