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Group or Agency <br /> <br />~,~barrut ~,ounfy Park~ and Reorenfion Pel;artrn~nf <br />P.O. Box 707, Conaord, NC 280~6-0707 <br /> <br />Inoentive ,rant Applioation <br /> <br />Fiscal I/ear 200.~ - 2004 <br /> <br />Date <br /> <br />Group or Agency Address <br /> <br />City <br /> <br />State <br /> <br />Zlpcode <br /> <br />Group or Agency President <br /> <br />Telephone Home <br /> <br />Business <br /> <br />Other <br /> <br />Email Address <br /> <br />Project Coordinator <br /> <br />Address <br /> <br />Telephone <br /> <br />Email Address <br /> <br />Home <br /> <br />Business <br /> <br />c~ <br /> <br /> State <br /> <br />Other <br /> <br />Zipcode <br /> <br />Project Title and Site <br /> <br />Is the Organization listed above non-profit? <br />Is this a new project or one that is ongoing? <br />What is your geographical area of service? <br /> <br />When is the project scheduled to start? End? <br /> <br />Will there be a fee charged for use? <br /> <br />Who will provide ongoing maintenance and repair of the completed project? (attach wdtten commitment) <br /> <br />What portion of the project cost does the sponsoring organization have now? <br /> <br /> * Current bank etatement {or equivalent) muet be attached to application, * <br /> <br /> <br />