Community Grant info

Verudgo Hills High School Booster Club

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Sunland-Tujunga & Shadow Hills Community Fund
APPLICATION

Date of Application. _______________________________________________________

Name of Organization _____________________________________________________

Name of Authorized Representative for the Organizaion___________________________

(Association with your organization will be confirmed prior to funds being released.)

Authorized Representative's Phone Number(s)__________________________________

E-Mail Address ~ _________________________________________________________

Description of Organization:

Description of Fundraising Event:

Reason for Fundraising Event:

Dates of Fundraising Event: Beginning on _____________ Ending on ____________

Feel free to attach separate sheets which describe your organization, your event and the reason for your event. Attach any other informational materials you may have available which further describe your fundraising event (such as flyers, newspaper articles or ads, graphic art, information about the outside event you wish to attend, pictures/descriptions of necessary items you wish to purchase, etc.).

Fundraising Goal $. ________ Requested Matching Grant Amount $ ____________

If awarded the grant, please indicate payee name: _______________________________

I certify I am an authorized representative for the organization. I have read, understand and have conveyed the information contained in the "Rules of the Sunland-Tujunga & Shadow Hills Community Fund" document to those involved with this fundraising event. My signature below confirms my organization will abide by the rules.
X ____________________________________ Print your name: ___________________
________________________________________________________________________

Mail or hand-deliver your completed form (and any other informational materials you wish to include) to:
Community Fund, c/o OK Trophy, 8337-D Foothill Boulevard, Sunland, CA 91040

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                                                                                                                                                                       For Grant Fund Use Only
Date Application Received __________________________                                              Approved ___                Denied ___
Number of votes FOR approval _____________                                                  Number of votes AGAINST approval ______
Actual amount raised at the event $.__________                                                  Amount dispersed to Organization $______
Check Number _____________                               Check Date ________

15 September 2009

Tuesday, August 02, 2011