Council and others responsible for event:
Financial Status of Local Council (amount of money in your treasury: $
Type of Program:
Location (Town, County, Building)
Targeted Population (Teachers, Parents, Administrators, School Board Members, etc.)
Presenter(s) Name(s) Please * any CCIRA Talent Bank Presentor
Please mark any of the following expenditures that will be included in the Grant:
Please give the details of the amounts requested for each of the above and the total cost:
Grant Income and Contributions from Council
CCIRA Seed Money
Talent Bank Mileage
Please provide details and amounts for each of the boxes checked above. Also, please include the total income. (Expenditures and Income totals must match)
If approved, we will need the following information: please provide the council name, council person, address, phone and email.
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