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<br /> <br /> <br /> <br /> <br /> 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 /> <br /> Agency Name: A + ~ Date: lV / <br /> Agency Mailing Address: O <br /> 5' <br /> ~-7 <br /> Agency Phone Number: / 03 'o 5'_:~A Agency Fax Numker: ©3 8'3 O a5 g <br /> Contact Person: Contact's Title: <br /> . <br /> Contact's Mailing Address: P. 6 BOX 'T7 PC},6 T7-*Y (a <br /> Contact's Phone Number: 1rn©~ -~~7 Contact's Fax Number: Q 3 ^-7 $3 <br /> Contact's Email Address: ' ■ 1 <br /> 4 <br /> Name of Project: Cl. <br /> Location/Service Area of Project: -71 6a, O <br /> Summary of Project: {r f` ~r <br /> car <br /> W(Wa <br /> 4e cly, r\ <br /> <br /> <br /> <br /> <br /> <br /> Describe how your project will benefit the ity of Paris and its citizens: <br /> ~r l C_~- <br /> t "i v-% <br /> <br /> v J <br /> r) (A CLX r <br /> ZS ei. 40A C11 q.0 + <br /> List other sources of fundin for this project and the amounts: I, <br /> Zee. ,(+fer\ (V-e (0) n <br /> c~ . <br /> Is a detailed project budget, including columns and descriptions for allocations of city funding and the agency's <br /> matching funds, attached? Ayes ❑ No <br /> <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?'Yes ❑ No <br /> <br /> If you have receivg4l previous city funding, list the name of the roject, the amount of the City's award, and the <br /> year awarded: <br /> <br /> <br /> <br /> City of Paris Revised 6/10/08 <br />