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REQUEST FOR PUBLIC FUNDING <br />Non-prafit agencies requesting funding fram the City of Paris.for pzojects that benefit the ejtf~f mplete <br />thc following infozmation tD be aligible far consideration (you rnay use addicianal pages, if neces p ~ Ple~e <br />submit witIa this farm a copy of your ageney's most recent financ9al staternent or audiC and a detai~ed bu gzt for the <br />project. A.gencies must al.so make a brief presentation on their project at a city council meeting. <br />Agency Name• a- i -t -e s Date; 7- 7- t D <br />Agency Maiting Address:.Jd 0' tC 23~7 cuAt P~ fL~Sctr►t T X'M <br />Agency Phone Number: 5' -4 ~3-- ~ Agency Fax Number: ~(~3 5~~+' ogtA <br />Contaet person: ~~rn ~ C~tos1~ ~r I C f~t ~e (~-~iS ~lcm Contact's TS.tIe: a}eevt~tx Qlfect~ R-- <br />~ • ~ <br />Contact's Maii[ng Address: Q. o rvL •qo - <br />Cantact's Phone Number:9'63 ~Ia 3 Contact's T;'ax Number:,.,~~ <br />Contact's Ernai1 Addrass: i~ec - - tc•c <br />0~~~u~c(n a~-~c~ h~,-n R'~ I 11ci~+,c P Je Q~S~iu +~crv~~i.l <br />NamB of Project:_..... ~----r-- <br />Agfs n4-h sui, PcCr ts - <br />Location/Service Area of Project: J <br />~Q ,gjy Total Amount Requested fram City; $~4, d~4 <br />Total Project Budget: $ <br />Number af Deneflcfaries:_-A9,,!C- Summas'y of pxoject: cr)5' <br />CL `SIS " <br />~t <br />Describe how your project will benefit tha City of Paris gnd its dtizens: 44a~i~ <br />kAdA n <br />- A , r i-L'R-INt (1~~aA S~~ r'~st ~5 <br />I.ist other sources of funding for this project an.d the amOunts: / - ~ <br />c. <br />r ~ ~~;oa~ . u,►,~.~f._._._~ ~5 ; <br />Z,2 3 14W 9' <br />. ~ • ~ - ~ s~ { s. . <br />Is a detailed project budget, including colurnns and descriptions [or allaeafions oF c1tY fnnding and the agency's <br />matehing Yundsi ettaehed? E~Yes ❑ No <br />Xs the agencp's bnost recent financiai statement or andi,t attachedT [t]'Yes No <br />Fiave you recetved funding from the City of Parie in the last five years for this or any other project? E?Tes ❑ No <br />IP yon have received prevlous funding tt'um the Clty, list f.he name of the praject, the amount of the City's award, <br />and the year awardeal: 2401--A0.606 <br />Re~ised ~1Q7104 <br />City oY Paris ~IBIT A <br />INd90~t ~IOZ 'Inf <br />E'd ZqBt.°N 'a'W 113MM1'M NOlNilO <br />