Community Promotional Fund Application
APPLICANT INFORMATION:
Name of applicant: Judy Livingston
Name of anganization or group represened: Mojave desert GenE Mineral Socrety Mailing address: P.0. Box 138, Barstow, Ca 92312
Contact phone numbers): 760-617-5300
Non-Profit? Yes) No If no, are you partnering with a non-profit:
PROJECT DESCRIPTION:
Amount requested: waiver of venue fees $ 2250ix (3dugs) What wil the funds be used for? the warier of fee, will be used to HARVEY Haust
secure Cona Harper Fitness Center for 3 days
When will the activity take place? December 6, 7, 8 2024 Where wil the activity take place? Core Har per fitness Haster Why are the funds needed? A warier of fees allis our club to contrive our scholarship program
How many Barstow area residents are involved with this organization? 35 How many spectators will watch this activity? 500 + visitons Please describe how this activity will benefit Barstow. If additional space is necessary, please attach additional sheets:
For more than to weary, the annual moBms Gem
Show has been a wholesomes activity and learning
opportunity for those who live in Barston. The show presents the mineral and rock wonders of our Maare Desert,
Many out of town visitorg to the show will use
Barsinw restaurants, motel and gas stations
Community Promotional Fund Application Page 1
Rev. August 2013
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.) Judith dingston Judith Livingston 07/23/24
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 Expense for 2029 Gen Show
$500.00 City If Barsow deposit
259.00
30.00 Raffee Registration
180.00 Food truck
87.00 Frostys donuts
100.00 Rapple Prize
73,88 rinting Solution.
32.50 Couater fait pens /tepe and despera
12.96 alert
219.92 Anazon crapt and art sepples
30.00 aroline for moving trailers
88.24 States Bros
$1533.50
....
The mozine Desert Sint minine Socie
is non profet and our axes.
Sem and Miral show is organized
and presented by volunteers. One
1 G our goals is a yearly progsem
to provide schrarships to local
studests._ Scholasships are funded,
By the " spin et her", 'that bage by the "Spin the Whel' annual Decenkes show.
A waiver of fees fos the use of
the Cora Harpe Jitness Certa
and psordes a venue. enables the dekdas ship langes.
enough to present the show.
ety of Barstow, thank you for
budget. obsite in your new
Jady Lungstor
Leasure
From: [email protected]
Subject: Pay.gov Payment Confirmation: Form 1023
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You successfully submitted your Form 1023 user fee payment to Pay.gov and the details are below. You can expect to be contacted about your application by the IRS within 180 days from the date you submitted it. After 180 days, if you haven't been contacted, you can call the toll-free Customer Account Services number, Monday through Friday, 8 a.m. - 5 p.m. (local time), at 877-829-5500 to check on the status. You will need to provide your name, your employer identification number (EIN), and the date you submitted your application when calling.
Application Name: Form 1023
Pay gov Tracking ID:
Agency Tracking ID:
Transaction Type: Sale
Transaction Date: 09/24/2024 02:49:52 PM EDT
Account Holder Name: Mojave Desert Gem and Mineral Society Transaction
Card Type:
Card Number:
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