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T( <br />REQUEST FOR PUBLIC FUNDING v <br />Non-profit agencies requesting funding from the City of Pans 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 addirion, 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 <br />Agency <br />Agency Phone Number:tfQ,j- <br />Contact <br />Contact's Mailing <br />Agency Fax Number: <br />Contact's Title• &-rnk1 <br />~ <br />Describe how your project will benefit the City of Paris and its <br /> <br />matching funds, attached? ( /~Yes ❑ No <br />Is t6e agency's most recent financial statement or audit attached? 10 Yes ❑ No i~_t. _ <br />M/~,e. <br />Have you received funding from the City of Paris in the last five years for this or any ther project? .e [~Yes ❑ No <br />If you have received previous city funding, bst the name of the project, the amount of the City's award, and the <br />year awarded:~n <br />t ~ ~ ~ ~C►.~ ~ 5 2p91~ ' <br />G~'!~ ~ t?O2> ~n ff <br />City of Paris EXHIBIT I I { l Revised 6/10/08 <br />Is a detailed project bndget, including columns and descriptions for allocations of city funding and the agency's <br />Contact's Phone Number:~ j-1 / V& i-tContact's Fax Number: <br />'T <br />ContacNs Finail Address:llr?wrM fi) afi~ „/C .4 u A <br />