MMIA Risk Management Training Endowment Application
Project Title/Name:
Date of Event
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Month
-
Day
Year
Date Picker Icon
Municipal Sponsor: (city, town, department)
Primary Contact
Primary Contact:
First Name
Last Name
E-mail
Phone Number
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Area Code
Phone Number
Mailing Address
Mailing Address 1
Mailing Address 2
City
State / Province
Postal / Zip Code
Abstract/Summary: (2-3 sentences that describe your project)
Participating Municipalities (Registration must include 10% of MMIA’s Member Entities)
Budget:
Overall Project Budget:
Total Request of the MMIA Endowment: (up to $2,000)
Endowment Request as Percentage of Total Budget:
Submit
Should be Empty: