Form to nominate

New Projects

Name of Organization

Address

Contact Person

Contact's Phone

City/State/Zip:

Contact’s Email:

Name of Project (if different):

Describe how El Dedon Verde could impact this organization/project:

Describe how El Dedon Verde could impact this organization/project: (copy)

Does this organization receive any assistance from state, federal, or United Way funding?

• Yes
• No

Specific amount requested (if any):

Other Information: Funding, if approved, is for the current year only. It does not involve on-going maintenance.

Today’s Date:

Member Proposing:

Member's Phone:

Member's Email

Email

Submit