AGENCY
NAME: |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
PROJECT /ACTIVITY NAME: |
|
|
|
CONTACT PERSON: |
|
|
|
ADDRESS: |
|
|
|
PHONE NUMBER: |
|
|
|
AMOUNT REQUESTED: |
|
|
|
|
|
|
|
|
|
|
|
When
does the fiscal year for the program being funded begin? |
|
|
|
|
|
|
Has
your organization received funding from the City previously ? |
|
|
|
|
|
|
If
so, what was the source and amount of funding received ? |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Description/Justification (Using
300 words or fewer, describe the program for which funding is being |
|
requested, the importance of the program and why City funding is
needed.) |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
This request should be supported (maximum of
three pages) with the following information: |
|
1. Description of funding
support received from all other sources such as the United Way, Douglas
County, |
|
USD 497, state/federal grants
and private funding. |
|
|
|
2. Total budget for the agency, number
of personnel, and how the funding would be used (e.g., personnel, |
|
|
equipment, material, etc.). |
|
|
|
3. Does the agency anticipate the need
to request funding beyond 2004? |
|
|
|
|
|
|
|
Additional information may be provided within
the three (3) page limit.
Submit 12 copies of this form and |
|
supporting material by April 14, 2003 to:
Debbie Van Saun, Asst. City Manager, Fourth Floor, City Hall, |
|
6
E. 6th Street, P.O. Box 708 Lawrence, KS 66044. Please do not submit the
material in a binder. |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|