LDPG Grant Application

Use this form for grant requests relating to NRG and/or Disaster Preparedness. It will be reviewed by the Larkspur Disaster Preparedness Group, a subcommittee of LCF with knowledge and expertise relating to disaster preparedness. 

INDIVIDUAL REQUESTING GRANT:
ORGANIZATION REQUESTING GRANT if applicable:
ADDRESS:
E-MAIL:
CONTACT PERSON:
PHONE (DAY):
-
PERSON RESPONSIBLE FOR MANAGING THE GRANT (Grant submitted by minors are to be managed with an adult):
DESCRIPTION OF PROJECT:
TIME FRAME FOR COMPLETION:
TOTAL BUDGET FOR PROJECT:
AMOUNT OF REQUEST:
ARE YOU SEEKING FUNDING FROM OTHER SOURCES?
IF YES, NAME THE ORGANIZATIONS AND FUNDING AMOUNT REQUESTED. (WE ENCOURAGE APPLICANTS TO PROVIDE MATCHING FUNDS OR IN-LIEU CONTRIBUTIONS SUCH AS LABOR OR MATERIALS.)
IF YOU DO NOT RECEIVE FUNDING FROM THIS GRANT REQUEST, WHAT ARE YOUR PLANS?
ADDITIONAL INFORMATION YOU WOULD LIKE US TO HAVE:.
SIGNATURE OF APPLICANT (and supervising adult if applicant is minor):
After clicking the Submit button, you will receive an email confirming your submission. If you do not receive an email or if you have any questions please contact us.

If you have questions or would like to discuss your application feel free to contact us at terry@tjstern.com .