CITY OF KANNAPOLIS
COVID-19 RELIEF FUNDS
AGENCY FUNDING APPLICATION
Agency Information
1. Agency Name: ___________________________________________________________________
2. Mailing Address: __________________________________________________________________
3. Physical Address, if different: ________________________________________________________
4. Main Phone #: ______________________________________
5. Website: ___________________________________________
5. Contact Person and Title: ___________________________________________________________
6. Contact’s Phone #: ___________________________________
7. Contact’s Email: _____________________________________
8. Agency’s Director: ___________________________________
9. Federal Tax ID Number: _______________________________
10. Amount of City of Kannapolis Funding Requested: (attach itemized budget) ______________
11. Amount of COVID-19 Relief Funds Received from other sources: ___________________
12. Provide an overview of how your agency will utilize funds to prevent, prepare or respond to COVID-19
virus and describe how COVID-19 has impacted your organization.