of Barston
Received: •
Community Promotional Fund Application
APPLICANT INFORMATION:
Clert
HERMAN WAGNER
Name of applicant:
Name of organization or group represented: IN 2) SATEs VeneRns Suppor Go, Tie.
Mailing address: / E, MAiN ST. BARSTOW, CA 12311
Contact phone numbers: 160220-7682
Non-Profit (Yes) No If no, are you partnering witha non-profit: 3-4292900 PROJECT DESCRIPTION:
Amount requested: 5 1, 770.00
What will the funds be used for?
When wil the activity lake place? 07/27/24
Why are the funds needed?
How many Barstow area residents are involved with this organization? 200 How many spectators will watch this activity? 300
Please describe how this activity will benefit Barstow. If additional space is necessary, please attach additional sheets:
Will ENhaner To LiViNg CONDiTTEN of OuR Kigs
LiVing YM BARSTOW, CA 92311
21k2 GiVE AWAY 20 MEW BIRES
7/500,0g IM toog voucheRs,
@ 1Ab/23 40 CHAIRS
Rev. August 2013 Community Promotional Fund Application Page 1 With this application, please attach the following:
1. A detailed budget stating the total cost of the activity or event, all sources and amounts of funding, and all expenses;
2. A description of the organization's or group's purpose or objective.
By signing below, I declare that I have read the City's Community Promotional Fund Policy and agree to all its terms and conditions. I understand that an incomplete application will not be accepted and that the organization or applicant will not be considered for funding. (If the application is being submitted on behalf of an organization or school, an additional signature is required.) Koberkintam maR 25,3024
Signature of Applicant Applicant Name (printed) & Date
School Principal or Organization
President/Director Signature
(if applicable)
Rev. August 2013 Community Promotional Fund Application Page 2