2
Project Contact Name: ____________________________________________________
Title: ___________________________________________________________________
Phone: _________________________________________________________________
Email Address: ___________________________________________________________
Fiscal Contact Name: _____________________________________________________
Phone: _________________________________________________________________
Email Address: ___________________________________________________________
Name and Title of Authorized Representative:
Acceptance of this application may be subject to subsequent compliance reviews, including a review
of the latest audit of financial statement. Preparation of an application does not guarantee that
applicants will receive funds. By signing this grant application form the undersigned certifies that all
information is accurate to the best of his/her knowledge.
__________________________________ ____________
Signature of Authorized Representative Date
PROPOSAL DETAILS
1. Applicant Profile and Qualifications: Tell us briefly about your organization including
your mission, history, and years of experience providing food and beverage services and
supervising employees(max. 250 words)