Rev. August 2013 Community Promotional Fund Application Page 1 Community Promotional Fund Application
APPLICANT INFORMATION:
Name of applicant: ______________________________________________________ Name of organization or group represented: __________________________________ Mailing address: ________________________________________________________ Contact phone number(s): ________________________________________________ Non-Profit? Yes No If no, are you partnering with a non-profit: _____________ PROJECT DESCRIPTION:
Amount requested: $________________
What will the funds be used for? ___________________________________________ ______________________________________________________________________ When will the activity take place? __________________________________________ Where will the activity take place? __________________________________________ Why are the funds needed? _______________________________________________ ______________________________________________________________________ How many Barstow area residents are involved with this organization? _____________ How many spectators will watch this activity? _________________________________ Please describe how this activity will benefit Barstow. If additional space is necessary, please attach additional sheets:
______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ ______________________________________________________________________ Rev. August 2013 Community Promotional Fund Application Page 2 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.) _______________________________ ________________________________ Signature of Applicant Applicant Name (printed) & Date
_______________________________
School Principal or Organization
President/Director Signature
(if applicable)