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, please print and mail a signed, completed application to: Terri Sternberg, 8 Monte Vista Avenue, Larkspur, CA 94939

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