Paragould Advertising & Promotion Commission-553264

APPLICATION FOR FUNDING

ORGANIZATION INFORMATION

Name of Organization

Physical Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code

Mailing Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code

Phone Number

Area Code Phone Number

Tax ID Number

Is this an incorporated non-profit organization

Yes No

CONTACT INFORMATION

Primary Contact Person

First Name Last Name

Phone Number

Area Code Phone Number

Email

example@example.com

Secondary Contact Person

First Name Last Name

Phone Number

Area Code Phone Number

Email

example@example.com

FUNDING DETAILS

Funding Details – please select type of funding requested

Event Funding - Food festival, softball tournament, auto show Annual Funding - Recurring funding for events, i.e. festivals, theaters Capital Project - Convention Center, Water-Park, Parks Start-Up Money - Enable an annual festival to become established Advertise and Publicity - To promote event in any form of media, brochures Arts - Art shows, dance competitions, musical performances

Name of Event/Project

Date

Location of Event/Project

Years Event/Project has Existed

Description of Event/Project

FINANCIAL INFORMATION

Amount Requested from A&P Commission

Total Budget for Event/Project

Source(s) of Other Funding

Is there a price of admission? If so, what is the price

Is the goal of the event to make a profit? If so, what will profits be used for?

Please estimate the following:

Total number of attendees

Number of out-of-town attendees

Number of overnight stays

Economic impact (terms of dollars spent in Paragould

For Sporting Event

Number of visiting teams

Number of visiting participants

Team Registration Fee Amount

If approved, specifically lists what A&P Funds will be used for.

Please use the space below for any additional comments.

Please attach the following documents

Proposed Event/Project Budget
List of Organization Board of Directors
Financial Information from past two years (Form 990, Audit etc.)
Articles of Incorporation (if applicable)
Event specific history. How many attendees, how many rooms booked etc.

All forms of advertsement/publicaton for an event or project using Paragould A&P funds must include text and/or
audio recognizing the event or project as funded by or made possible by the Paragould Advertsing and Promoton
Commission. Please include logo as well where appropriate.

By signing below, I acknowledge that I have prepared this request with correct informaton to the best of my knowledge.
I also agree that I understand and agree to abide by guidelines for funding. I also agree to provide a follow-up report and
expense documentaton within 60 days of completon of the event.

By signing below, I also acknowledge that I indemnify the Paragould Advertsing and Promotons Commission and the
City of Paragould of any liability associated with the organizaton or event.

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Signature

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