Grant Application Form Applicant InformationOrganization*Contact Name*Telephone/Office*Cell*Email* (Name and Event) Mailing Address* Street Address City State / Province / Region ZIP / Postal Code Program/Project or Event Description – Please Add Additional Sheet(s) If Needed Project/Event InformationProgram/Project or Event Description*Date(s) of Event* Date Format: MM slash DD slash YYYY Location*Amount Requested($)*Non-Profit Organization*YesNoTax I.D. #*This Information Is RequiredDo you carry event insurance?*YesNoIf YES, Name of CarrierPolicy NumberIs this a one-time program/project/event or recurring?*one-timerecurringIf recurring, how frequentlyHas the Campbell County CVB funded this event in the past?*YesNoIf YES, number of times & amount received to dateIs event public or private?*PublicPrivateHas venue/facility been secured?*YesNoIf so, please listHas hotel or campground been secured?*YesNoIf YES, Please list hotel(s) &/or campground(s)Did the CCCVB send an RFP to all lodging properties? (REQUIRED)*YesNoINFORMATION FOR TOURISM DEVELOPMENT PORTION OF APPLICATION - SCORING 25 POINTS MAX.Anticipated # of out-of-town overnight visitors*Anticipated # of attendees:*Anticipated # of Room Nights (Dates, # rooms, # nights)*Room Night History of Event (if applicable)(Dates, Hotel & Contact Name, # rooms, # nights)How does this event contribute to the overall appeal of Campbell County as a preferred visitor destination?*Please list target markets that program/project or event will impact and how will it be marketed?*INFORMATION FOR EVALUATION PORTION OF APPLICATION - SCORING 25 POINTS MAX.How does the program/project or event support your organization’s mission and the mission of the CCCVB?*Total Projected Budget ($)*Total Projected Revenue ($)*Please attach budget with applicationAny income coming from sponsorships ($)*Any income coming from donations ($)*Any income coming from admission fees ($)*Any income coming from other grants ($)*If you are requesting or anticipating receiving funding for this program/project or event from other sources, please list each source and the amount requested/anticipated (Amount Requested, Source, Amount Received)Total Income/Funding Requested/Anticipated ($)*Describe how grant funds would be used*Describe how you will evaluate the outcome of the program/project or special event*Additional information/commentsSignature*Title*Date* Date Format: MM slash DD slash YYYY *Please note that incomplete applications will be returned. Carefully read and follow grant guidelines.** Grant Applications will be reviewed four times per year, the second Thursday of the month at the Campbell County Lodging Tax Joint Powers Board meetings in March, June, September, and December. Be sure to submit your requests as early as possible so they may be reviewed on a timely basis.
