Fillable Form 368 Application (City of College Park, Maryland)

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Form 368 Application (City of College Park, Maryland)

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The Form 368 Application (City of College Park, Maryland) form is 2 pages long and contains:

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File type: PDF

U.S.A. forms for City of College Park, Maryland

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CEMGP Application Page 1 of 2 7/16/2014 4:06 PM
Department of Public Services
4601-A Calvert Road
College Park, MD 20740
Telephone: 240-487-3570 Facsimile: 301-864-7965
Email:
publicservices@collegeparkmd.gov
OFFICE USE ONLY
Date Received ________________
Council District ________________
Amount Requested ________________
Date Granted ________________
Date Denied ________________
Amount Awarded ________________
Community Event Micro Grant Program
Application
Neighborhood (select one below):
Autoville
Calvert Hills
Crystal Springs
Hollywood West
Oak Springs West
Berwyn
Cherry Hill
Daniels Park East
Lakeland
Old Town & Kropps Addition
Branchville East
College Park Estates
Daniels Park West
Lord Calvert Manor (Knox boxes)
Sunnyside
Branchville West
College Park Woods
Hollywood East
Oak Springs East
Yarrow
PLEASE PRINT OR TYPE
Name of Organization or Group:
Representative:
Address:
Email Address:
Day Time Phone
Primary Contact, if different from above:
Name:
Address:
Email Address:
Day Time Phone
Describe the event, intended location and date:
How many participants do you expect? Volunteers Residents Other
How wi
ll this event impact your neighborhood?
List the intended goal(s) of the event
Provide a line by line budget with narrative detailing intended use of requested funds for thi
s event.
List intended vendors for this event (see restrictions in Community Event Micro Grant Program Policy)
CEMGP Application Page 2 of 2 7/16/2014 4:06 PM
Department of Public Services
4601-A Calvert Road
College Park, MD 20740
Telephone: 240-487-3570 Facsimile: 301-864-7965
Email:
publicservices@collegeparkmd.gov
OFFICE USE ONLY
Date Received ________________
Council District ________________
Amount Requested ________________
Date Granted ________________
Date Denied ________________
Amount Awarded ________________
Community Event Micro Grant Program
Application
Hold Harmless Agreement
(Must be signed and submitted with the completed application)
In consideration for the receipt of certain grant monies from the City of College Park, and
other good and valuable consideration, receipt and sufficiency of which is hereby acknowledged,
___________________________________________ (name of organization) does hereby agree
to indemnify and hold the City of College Park, its agents, servants, employees and officials,
harmless from and against any and all claims, demands, actions, causes of action, suits, and
proceedings by others, and against all liability for damages, including attorneys’ fees, incurred
by reason of or arising from any program, class, equipment or activity for which funds provided
by the City of College Park are used directly or indirectly, regardless of whether or not the City
is named as a sponsor.
Organization:
Signature of Authorized Representative:
Printed Name:
Title:
Date:
Submit by Email
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Form 368 Application (City of College Park, Maryland)

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Completed 14 July 2020

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