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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 meetinQ. <br />, „ . . <br />Agency Name• <br />Agency Mailing Address: <br />Agency Phone Number: ~ <br />" _T <br />Contact Person: <br />Contact's Mailing Address <br />Contact's Phone Number: <br />Contact's Email Address: I G <br />Name of Project: NlIp.15 Qn <br />Location/Service Area of Project: <br />Summary of Project _S Qe-, <br />~n r S <br />Agency Fax Num <br />Contact's Fax Number: <br />; n <br />Describe how your project will benefit the City of Paris and its citizens: <br />I i <br />List other sources of funding for this roject and the amounts: <br />Is a detailed project budget, including columns and descriptions for allocations of city funding and the agency's <br />matching funds, attached? NKes E] N. <br />Is the agency's most recent financial statement or audit attached? ( 1'es f] No <br />Have you received funding from the City of Paris in the last five years for this or any other project? 21reS[] No <br />If you have received previous city funding, st the name of the project, the amount of the City's award, and the <br />year awarded: Se e- <br />City of Paris <br />E y H I.eI•r A Revised 6/10/08 <br />