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Name/Organization *
Phone *
Fax
Contact Name *
Email *
screened? percentage you,
Are you a Governmental Entity? * Yes No
Event *
Amount Requested *
Property Requested
In-Kind Service Requested
Funding Category * Economic Development Recreation/Athletic Advertise/Market Use of City Property for Public Benefit Arts/Cultural Partnership-Endeavor Aid to the Needy Educational
If you are a for-profit applicant, what is the expected private benefit to you, your partners, or members of a club if any part of any fundraising goes to an organization and part to some charitable cause? What is percentage breakdown shown in actual projections?
What is (are) the goal(s) of this project? (In one sentence) *
If a governmental entity, is the cooperative endeavor or intergovernmental agreement sought pursuant to local services law, joint emergency preparedness, exchange of surplus property for public safety purposes, or other? (State “other” reason).
If the use of public funds or property is for social welfare for the aid and support of the needy, how are targeted candidates screened? If not screened, how are they targeted for participation?
Does your request or endeavor involve a nearly equal benefit to the citizens you seek to serve when compared to the money or property expended or sought to be used by the public entity? If so, how? *
If you cannot show a fair market value dollar-for-dollar match, does your plan or request involve a continuing program or relationship which has a future value attached? How so?
What are your real and substantial obligations to achieve the proportionate return to the City of Alexandria at some point in the future? *
What is (are) the expected outcome(s) or benefits(s) to the public from the event to be funded? Specify the number of persons anticipated to be served and the service(s) to be provided. *
Describe the history of this program and its success. *
Projected number of out-of-town participants and guests
Identify broadcast, web and regional print promotions to be utilized
Average number of days stay by out-of-town guests to this event
Number of People
Number of Days