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<DIV><FONT face=Arial size=2>Art, this is an example of mass emailing with a
Word doc inserted.</FONT></DIV>
<DIV><FONT face=Arial size=2></FONT> </DIV>
<DIV><FONT face=Arial size=2></FONT> </DIV>
<DIV><FONT face=Arial size=2>
<DIV><FONT face=Arial size=2>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt; TEXT-ALIGN: center" align=left><B
style="mso-bidi-font-weight: normal"><SPAN
style="FONT-SIZE: 14pt; FONT-FAMILY: 'Antique Olive'"><FONT
face="Times New Roman"></FONT></SPAN></B> </P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt; TEXT-ALIGN: center"
align=center><B style="mso-bidi-font-weight: normal"><SPAN
style="FONT-SIZE: 14pt; FONT-FAMILY: 'Antique Olive'"><FONT
face="Times New Roman"></FONT></SPAN></B> </P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt; TEXT-ALIGN: center"
align=center><B style="mso-bidi-font-weight: normal"><SPAN
style="FONT-SIZE: 14pt; FONT-FAMILY: 'Antique Olive'"><FONT
face="Times New Roman">2006 Member Requested<?xml:namespace prefix = o ns =
"urn:schemas-microsoft-com:office:office" /><o:p></o:p></FONT></SPAN></B></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt; TEXT-ALIGN: center"
align=center><B style="mso-bidi-font-weight: normal"><SPAN
style="FONT-SIZE: 14pt; FONT-FAMILY: 'Antique Olive'"><FONT
face="Times New Roman">Local Community Project Information
Form<o:p></o:p></FONT></SPAN></B></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt; TEXT-ALIGN: center"
align=center><B style="mso-bidi-font-weight: normal"><SPAN
style="FONT-SIZE: 14pt; FONT-FAMILY: 'Antique Olive'"><FONT
face="Times New Roman"> <o:p></o:p></FONT></SPAN></B></P>
<TABLE style="BORDER-COLLAPSE: collapse; mso-padding-alt: 0in 5.4pt 0in 5.4pt"
cellSpacing=0 cellPadding=0 border=0>
<TBODY>
<TR>
<TD
style="BORDER-RIGHT: #ece9d8; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 3.95in; PADDING-TOP: 0in; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent"
vAlign=top width=379>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt; tab-stops: 217.5pt"><B
style="mso-bidi-font-weight: normal"><FONT face="Times New Roman">Project
Name: ________________________________<o:p></o:p></FONT></B></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt; tab-stops: 217.5pt"><B
style="mso-bidi-font-weight: normal"><FONT
face="Times New Roman"> <o:p></o:p></FONT></B></P>
<P class=MsoNormal
style="MARGIN: 0in 0in 0pt; LINE-HEIGHT: 150%; tab-stops: .25in"><FONT
face="Times New Roman">Address of Project Site:<SPAN
style="mso-spacerun: yes"> </SPAN>_<B
style="mso-bidi-font-weight: normal">________________________<o:p></o:p></B></FONT></P>
<P class=MsoNormal
style="MARGIN: 0in 0in 0pt; LINE-HEIGHT: 150%; tab-stops: .25in"><FONT
face="Times New Roman"><SPAN
style="mso-spacerun: yes">
</SPAN>_<B
style="mso-bidi-font-weight: normal">________________________<o:p></o:p></B></FONT></P></TD>
<TD
style="BORDER-RIGHT: #ece9d8; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 3.1in; PADDING-TOP: 0in; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent"
vAlign=top width=298>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt"><B
style="mso-bidi-font-weight: normal"><FONT
face="Times New Roman">Legislative District: </FONT></B><U><SPAN
style="FONT-FAMILY: Arial">_____________</SPAN></U></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt"><FONT
face="Times New Roman"> <B
style="mso-bidi-font-weight: normal"><o:p></o:p></B></FONT></P></TD></TR>
<TR>
<TD
style="BORDER-RIGHT: #ece9d8; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 3.95in; PADDING-TOP: 0in; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent"
vAlign=top width=379>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt; LINE-HEIGHT: 150%"><FONT
face="Times New Roman"><B style="mso-bidi-font-weight: normal">Project
Contact</B><SPAN
style="mso-tab-count: 3">
</SPAN></FONT></P>
<P class=MsoNormal
style="MARGIN: 0in 0in 0pt; LINE-HEIGHT: 150%; tab-stops: .25in"><FONT
face="Times New Roman">Name(s)<SPAN style="mso-spacerun: yes">
</SPAN><B
style="mso-bidi-font-weight: normal">_____________________________________</B></FONT></P>
<P class=MsoNormal
style="MARGIN: 0in 0in 0pt; LINE-HEIGHT: 150%; tab-stops: .25in"><FONT
face="Times New Roman">Title <B style="mso-bidi-font-weight: normal"><SPAN
style="mso-spacerun: yes"> </SPAN>________________________________________</B></FONT></P>
<P class=MsoNormal
style="MARGIN: 0in 0in 0pt; LINE-HEIGHT: 150%; tab-stops: .25in"><FONT
face="Times New Roman">Organization<B
style="mso-bidi-font-weight: normal"><SPAN
style="mso-spacerun: yes">
</SPAN>_________________________________</B></FONT></P>
<P class=MsoNormal
style="MARGIN: 0in 0in 0pt; LINE-HEIGHT: 150%; tab-stops: .25in"><FONT
face="Times New Roman">Phone:<B style="mso-bidi-font-weight: normal">
_________________</B><SPAN style="mso-spacerun: yes"> </SPAN>Fax: <B
style="mso-bidi-font-weight: normal">________________</B></FONT></P>
<P class=MsoNormal
style="MARGIN: 0in 0in 0pt; LINE-HEIGHT: 150%; tab-stops: .25in"><FONT
face="Times New Roman">E-Mail: <B
style="mso-bidi-font-weight: normal">______________________________________<o:p></o:p></B></FONT></P>
<P class=MsoNormal
style="MARGIN: 0in 0in 0pt; LINE-HEIGHT: 150%; tab-stops: .25in"><FONT
face="Times New Roman">Mailing Address: ______<B
style="mso-bidi-font-weight: normal">________________________<o:p></o:p></B></FONT></P>
<P class=MsoNormal
style="MARGIN: 0in 0in 0pt; LINE-HEIGHT: 150%; tab-stops: .25in"><FONT
face="Times New Roman"><SPAN
style="mso-spacerun: yes">
</SPAN>______<B
style="mso-bidi-font-weight: normal">________________________<o:p></o:p></B></FONT></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt; tab-stops: .25in"><FONT
face="Times New Roman"> <U><o:p></o:p></U></FONT></P></TD>
<TD
style="BORDER-RIGHT: #ece9d8; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 3.1in; PADDING-TOP: 0in; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent"
vAlign=top width=298>
<P class=MsoNormal
style="MARGIN: 0in 0in 0pt 0.25in; LINE-HEIGHT: 150%; tab-stops: .25in"><FONT
face="Times New Roman"><B style="mso-bidi-font-weight: normal">Legislative
Sponsor:</B><BR><B
style="mso-bidi-font-weight: normal">____________________________<o:p></o:p></B></FONT></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt 0.25in; tab-stops: .25in"><B
style="mso-bidi-font-weight: normal"><FONT
face="Times New Roman"> <o:p></o:p></FONT></B></P>
<P class=MsoNormal
style="MARGIN: 0in 0in 0pt 0.25in; tab-stops: .25in"><FONT
face="Times New Roman"><B style="mso-bidi-font-weight: normal">Funding
Requested:</B><SPAN style="mso-spacerun: yes"> </SPAN>$<B
style="mso-bidi-font-weight: normal">__________</B><U><o:p></o:p></U></FONT></P>
<P class=MsoNormal
style="MARGIN: 0in 0in 0pt 0.25in; tab-stops: .25in"><FONT
face="Times New Roman"><I style="mso-bidi-font-style: normal">(Note:<SPAN
style="mso-spacerun: yes"> </SPAN>Funds are available on a
reimbursement basis only and cannot be
advanced.)</I><U><o:p></o:p></U></FONT></P></TD></TR></TBODY></TABLE>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt; tab-stops: .25in"><B
style="mso-bidi-font-weight: normal"><FONT size=3><FONT
face="Times New Roman">Project Information (attach separate page with additional
details if available):<o:p></o:p></FONT></FONT></B></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt 0.25in; tab-stops: .25in"><FONT
size=3><FONT face="Times New Roman"><SPAN
style="mso-tab-count: 1"> </SPAN>Brief Project
Summary, including project location and the public benefit the project
provides:</FONT></FONT></P>
<P class=MsoNormal
style="MARGIN: 6pt 0in 0pt; LINE-HEIGHT: 150%; tab-stops: .25in"><U><FONT
size=3><SPAN
style="FONT-FAMILY: Arial; mso-bidi-font-family: 'Times New Roman'"><SPAN
style="mso-tab-count: 3">
</SPAN><SPAN
style="mso-tab-count: 3">
</SPAN><SPAN
style="mso-tab-count: 3">
</SPAN><SPAN
style="mso-tab-count: 3">
</SPAN><SPAN
style="mso-tab-count: 3">
</SPAN><SPAN
style="mso-tab-count: 3">
</SPAN><SPAN
style="mso-tab-count: 3">
</SPAN><SPAN
style="mso-tab-count: 3">
</SPAN><SPAN
style="mso-tab-count: 3">
</SPAN><SPAN
style="mso-tab-count: 3">
</SPAN><SPAN
style="mso-tab-count: 3">
</SPAN><SPAN
style="mso-tab-count: 3">
</SPAN><SPAN
style="mso-tab-count: 2">
</SPAN><SPAN style="mso-tab-count: 1">
</SPAN>________________</SPAN><o:p></o:p></FONT></U></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt 0.25in; tab-stops: .25in"><FONT
size=3><FONT face="Times New Roman"><SPAN
style="mso-tab-count: 1"> </SPAN>Start and
Completion Dates:<B style="mso-bidi-font-weight: normal"> ____________</B> to
_____<B style="mso-bidi-font-weight: normal">_______</B></FONT></FONT></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt 0.25in; tab-stops: .25in"><FONT
face="Times New Roman"><FONT size=3><SPAN
style="mso-tab-count: 1"> </SPAN><SPAN
style="mso-bookmark: Check1"><SPAN style="FONT-SIZE: 16pt"><A
name=Check1></A></SPAN></SPAN><SPAN
style="mso-bookmark: Check1"></SPAN></FONT><SPAN style="FONT-SIZE: 16pt"><SPAN
style="mso-spacerun: yes"> </SPAN></SPAN><FONT size=3>Attachments<SPAN
style="mso-spacerun: yes"> </SPAN></FONT><SPAN
style="FONT-SIZE: 10pt">(Please enclose any materials that further describe the
project and its financing.)</SPAN><B style="mso-bidi-font-weight: normal"><FONT
size=3> <o:p></o:p></FONT></B></FONT></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt 0.25in; tab-stops: .25in"><B
style="mso-bidi-font-weight: normal"><FONT size=3><FONT
face="Times New Roman"> <o:p></o:p></FONT></FONT></B></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt; tab-stops: .25in"><FONT
face="Times New Roman"><FONT size=3><B
style="mso-bidi-font-weight: normal">Eligible Project Type or Phase</B>
</FONT><SPAN style="FONT-SIZE: 10pt">(Check all that apply to this funding
request)</SPAN></FONT></P>
<TABLE style="BORDER-COLLAPSE: collapse; mso-padding-alt: 0in 5.4pt 0in 5.4pt"
cellSpacing=0 cellPadding=0 border=0>
<TBODY>
<TR>
<TD
style="BORDER-RIGHT: #ece9d8; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 4.95in; PADDING-TOP: 0in; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent"
vAlign=top width=475>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt; tab-stops: .25in"><FONT
face="Times New Roman"> <o:p></o:p></FONT></P></TD>
<TD
style="BORDER-RIGHT: #ece9d8; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 2.1in; PADDING-TOP: 0in; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent"
vAlign=top width=202>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt; tab-stops: .25in"><B
style="mso-bidi-font-weight: normal"><FONT face="Times New Roman">% of
Request</FONT></B></P></TD></TR>
<TR>
<TD
style="BORDER-RIGHT: #ece9d8; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 4.95in; PADDING-TOP: 0in; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent"
vAlign=top width=475>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt; tab-stops: .25in"><SPAN
style="mso-bookmark: Text15"><SPAN style="FONT-SIZE: 16pt"><A
name=Check2></A><A name=Text15></A></SPAN></SPAN><SPAN
style="mso-bookmark: Text15"><SPAN
style="mso-bookmark: Check2"></SPAN></SPAN><SPAN
style="mso-bookmark: Text15"><FONT face="Times New Roman"><SPAN
style="FONT-SIZE: 16pt"><SPAN
style="mso-spacerun: yes"> </SPAN></SPAN>Land
acquisition</FONT></SPAN></P></TD><SPAN style="mso-bookmark: Text15"><FONT
face="Times New Roman"></FONT></SPAN>
<TD
style="BORDER-RIGHT: #ece9d8; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 2.1in; PADDING-TOP: 0in; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent"
vAlign=top width=202>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt; tab-stops: .25in"><FONT
face="Times New Roman"><B style="mso-bidi-font-weight: normal"><U><SPAN
style="mso-spacerun: yes">
</SPAN></U></B><U>%<o:p></o:p></U></FONT></P></TD></TR>
<TR>
<TD
style="BORDER-RIGHT: #ece9d8; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 4.95in; PADDING-TOP: 0in; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent"
vAlign=top width=475>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt; tab-stops: .25in"><SPAN
style="FONT-SIZE: 16pt"><A name=Check3></A></SPAN><SPAN
style="mso-bookmark: Check3"></SPAN><FONT face="Times New Roman"><SPAN
style="FONT-SIZE: 16pt"><SPAN
style="mso-spacerun: yes"> </SPAN></SPAN>Demolition and site
preparation<SPAN style="FONT-SIZE: 16pt"><o:p></o:p></SPAN></FONT></P></TD>
<TD
style="BORDER-RIGHT: #ece9d8; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 2.1in; PADDING-TOP: 0in; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent"
vAlign=top width=202>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt; tab-stops: .25in"><FONT
face="Times New Roman"><B style="mso-bidi-font-weight: normal"><U><SPAN
style="mso-spacerun: yes">
</SPAN></U></B><U>%<o:p></o:p></U></FONT></P></TD></TR>
<TR>
<TD
style="BORDER-RIGHT: #ece9d8; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 4.95in; PADDING-TOP: 0in; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent"
vAlign=top width=475>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt; tab-stops: .25in"><SPAN
style="FONT-SIZE: 16pt"><A name=Check4></A></SPAN><SPAN
style="mso-bookmark: Check4"></SPAN><FONT face="Times New Roman"><SPAN
style="FONT-SIZE: 16pt"><SPAN
style="mso-spacerun: yes"> </SPAN></SPAN>Design<SPAN
style="FONT-SIZE: 16pt"><o:p></o:p></SPAN></FONT></P></TD>
<TD
style="BORDER-RIGHT: #ece9d8; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 2.1in; PADDING-TOP: 0in; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent"
vAlign=top width=202>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt; tab-stops: .25in"><FONT
face="Times New Roman"><B style="mso-bidi-font-weight: normal"><U><SPAN
style="mso-spacerun: yes">
</SPAN></U></B><U>%<o:p></o:p></U></FONT></P></TD></TR>
<TR>
<TD
style="BORDER-RIGHT: #ece9d8; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 4.95in; PADDING-TOP: 0in; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent"
vAlign=top width=475>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt; tab-stops: .25in"><SPAN
style="FONT-SIZE: 16pt"><A name=Check5></A></SPAN><SPAN
style="mso-bookmark: Check5"></SPAN><FONT face="Times New Roman"><SPAN
style="FONT-SIZE: 16pt"><SPAN
style="mso-spacerun: yes"> </SPAN></SPAN>New Construction<SPAN
style="FONT-SIZE: 16pt"><o:p></o:p></SPAN></FONT></P></TD>
<TD
style="BORDER-RIGHT: #ece9d8; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 2.1in; PADDING-TOP: 0in; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent"
vAlign=top width=202>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt; tab-stops: .25in"><FONT
face="Times New Roman"><B style="mso-bidi-font-weight: normal"><U><SPAN
style="mso-spacerun: yes">
</SPAN></U></B><U>%<o:p></o:p></U></FONT></P></TD></TR>
<TR>
<TD
style="BORDER-RIGHT: #ece9d8; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 4.95in; PADDING-TOP: 0in; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent"
vAlign=top width=475>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt; tab-stops: .25in"><SPAN
style="FONT-SIZE: 16pt"><A name=Check6></A></SPAN><SPAN
style="mso-bookmark: Check6"></SPAN><FONT face="Times New Roman"><SPAN
style="FONT-SIZE: 16pt"><SPAN
style="mso-spacerun: yes"> </SPAN></SPAN>Renovation<SPAN
style="mso-tab-count: 1">
</SPAN><SPAN style="FONT-SIZE: 16pt"><o:p></o:p></SPAN></FONT></P></TD>
<TD
style="BORDER-RIGHT: #ece9d8; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 2.1in; PADDING-TOP: 0in; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent"
vAlign=top width=202>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt; tab-stops: .25in"><FONT
face="Times New Roman"><B style="mso-bidi-font-weight: normal"><U><SPAN
style="mso-spacerun: yes">
</SPAN></U></B><U>%<o:p></o:p></U></FONT></P></TD></TR>
<TR>
<TD
style="BORDER-RIGHT: #ece9d8; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 4.95in; PADDING-TOP: 0in; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent"
vAlign=top width=475>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt; tab-stops: .25in"><SPAN
style="FONT-SIZE: 16pt"><A name=Check7></A></SPAN><SPAN
style="mso-bookmark: Check7"></SPAN><FONT face="Times New Roman"><SPAN
style="FONT-SIZE: 16pt"><SPAN
style="mso-spacerun: yes"> </SPAN></SPAN>Other (describe) <B
style="mso-bidi-font-weight: normal">________________________________________</B><SPAN
style="FONT-SIZE: 16pt"><o:p></o:p></SPAN></FONT></P></TD>
<TD
style="BORDER-RIGHT: #ece9d8; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 2.1in; PADDING-TOP: 0in; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent"
vAlign=top width=202>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt; tab-stops: .25in"><FONT
face="Times New Roman"><B style="mso-bidi-font-weight: normal"><U><SPAN
style="mso-spacerun: yes">
</SPAN></U></B><U>%<o:p></o:p></U></FONT></P></TD></TR>
<TR>
<TD
style="BORDER-RIGHT: #ece9d8; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 4.95in; PADDING-TOP: 0in; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent"
vAlign=top width=475>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt; tab-stops: .25in"><FONT
face="Times New Roman"> <SPAN
style="FONT-SIZE: 16pt"><o:p></o:p></SPAN></FONT></P></TD>
<TD
style="BORDER-RIGHT: #ece9d8; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 2.1in; PADDING-TOP: 0in; BORDER-BOTTOM: #ece9d8; BACKGROUND-COLOR: transparent"
vAlign=top width=202>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt; tab-stops: .25in"><FONT
face="Times New Roman"><B style="mso-bidi-font-weight: normal"><U><SPAN
style="mso-spacerun: yes">
</SPAN></U></B><U>%</U> <I style="mso-bidi-font-style: normal"><SPAN
style="FONT-SIZE: 10pt">(should equal
100%)</SPAN></I><U><o:p></o:p></U></FONT></P></TD></TR></TBODY></TABLE>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt 0.25in; tab-stops: .25in"><FONT
size=3><FONT face="Times New Roman"><SPAN
style="mso-tab-count: 2">
</SPAN><SPAN
style="mso-tab-count: 2">
</SPAN><SPAN
style="mso-tab-count: 2">
</SPAN><SPAN
style="mso-tab-count: 2">
</SPAN><SPAN
style="mso-tab-count: 2">
</SPAN></FONT></FONT></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt; tab-stops: .25in"><B
style="mso-bidi-font-weight: normal"><FONT size=3><FONT
face="Times New Roman">Organization Information<SPAN
style="mso-tab-count: 1"> </SPAN><SPAN
style="mso-tab-count: 3">
</SPAN><SPAN
style="mso-tab-count: 3">
</SPAN><SPAN
style="mso-tab-count: 2">
</SPAN>Yes<SPAN style="mso-tab-count: 1">
</SPAN>No<o:p></o:p></FONT></FONT></B></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt 0.25in; tab-stops: .25in"><FONT
face="Times New Roman"><FONT size=3><SPAN
style="mso-tab-count: 1"> </SPAN>Is applicant
registered with the state as a non-profit organization?<SPAN
style="mso-tab-count: 2">
</SPAN><SPAN style="mso-tab-count: 1">
</SPAN><SPAN style="mso-bookmark: Check8"><SPAN style="FONT-SIZE: 16pt"><A
name=Check8></A></SPAN></SPAN><SPAN
style="mso-bookmark: Check8"></SPAN></FONT><SPAN style="FONT-SIZE: 16pt"><SPAN
style="mso-tab-count: 1"> </SPAN></SPAN><SPAN
style="mso-bookmark: Check9"><SPAN style="FONT-SIZE: 16pt"><A
name=Check9></A></SPAN></SPAN><SPAN style="mso-bookmark: Check9"></SPAN><SPAN
style="FONT-SIZE: 16pt"><o:p></o:p></SPAN></FONT></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt 0.25in; tab-stops: .25in"><FONT
face="Times New Roman"><SPAN style="FONT-SIZE: 16pt"><SPAN
style="mso-tab-count: 1"> </SPAN></SPAN><FONT
size=3>Does applicant have current or pending 501(c)(3) IRS registration?<SPAN
style="mso-tab-count: 2">
</SPAN><SPAN style="mso-tab-count: 1">
</SPAN><SPAN style="mso-bookmark: Check12"><SPAN style="FONT-SIZE: 16pt"><A
name=Check12></A></SPAN></SPAN><SPAN
style="mso-bookmark: Check12"></SPAN></FONT><SPAN style="FONT-SIZE: 16pt"><SPAN
style="mso-tab-count: 1"> </SPAN></SPAN><SPAN
style="mso-bookmark: Check13"><SPAN style="FONT-SIZE: 16pt"><A
name=Check13></A></SPAN></SPAN><SPAN style="mso-bookmark: Check13"></SPAN><SPAN
style="FONT-SIZE: 16pt"><o:p></o:p></SPAN></FONT></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt 0.25in; tab-stops: .25in"><FONT
face="Times New Roman"><FONT size=3><SPAN
style="mso-tab-count: 1"> </SPAN>If answered <B
style="mso-bidi-font-weight: normal">no</B> to either of the above, is applicant
a local government?<SPAN style="mso-tab-count: 1">
</SPAN><SPAN style="mso-tab-count: 1">
</SPAN><SPAN style="FONT-SIZE: 16pt"></SPAN></FONT><SPAN
style="FONT-SIZE: 16pt"><SPAN style="mso-tab-count: 1">
</SPAN></SPAN><SPAN style="FONT-SIZE: 16pt"></SPAN></FONT></P><B
style="mso-bidi-font-weight: normal"><SPAN
style="FONT-SIZE: 12pt; FONT-FAMILY: 'Times New Roman'; mso-fareast-font-family: 'Times New Roman'; mso-ansi-language: EN-US; mso-fareast-language: EN-US; mso-bidi-language: AR-SA"><BR
style="PAGE-BREAK-BEFORE: always" clear=all></SPAN></B>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt; tab-stops: .25in"><B
style="mso-bidi-font-weight: normal"><FONT size=3><FONT
face="Times New Roman">Project Questions<SPAN
style="mso-tab-count: 1"> </SPAN><SPAN
style="mso-tab-count: 3">
</SPAN><SPAN
style="mso-tab-count: 3">
</SPAN><SPAN
style="mso-tab-count: 2">
</SPAN><SPAN style="mso-tab-count: 1">
</SPAN>Yes<SPAN style="mso-tab-count: 1">
</SPAN>No<o:p></o:p></FONT></FONT></B></P>
<TABLE style="BORDER-COLLAPSE: collapse; mso-padding-alt: 0in 5.4pt 0in 5.4pt"
cellSpacing=0 cellPadding=0 border=0>
<TBODY>
<TR style="HEIGHT: 0.3in">
<TD
style="BORDER-RIGHT: #ece9d8; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 5.95in; PADDING-TOP: 0in; BORDER-BOTTOM: #ece9d8; HEIGHT: 0.3in; BACKGROUND-COLOR: transparent"
vAlign=top width=571>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt; tab-stops: .25in"><FONT
face="Times New Roman">Is this a joint project?<SPAN
style="mso-tab-count: 1"> </SPAN></FONT></P></TD>
<TD
style="BORDER-RIGHT: #ece9d8; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 1.1in; PADDING-TOP: 0in; BORDER-BOTTOM: #ece9d8; HEIGHT: 0.3in; BACKGROUND-COLOR: transparent"
vAlign=top width=106>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt; tab-stops: .25in"><FONT
face="Times New Roman"><SPAN style="FONT-SIZE: 16pt"><SPAN
style="mso-spacerun: yes"> </SPAN></SPAN><SPAN
style="FONT-SIZE: 16pt"><A name=Check14></A></SPAN><SPAN
style="mso-bookmark: Check14"></SPAN><SPAN style="FONT-SIZE: 16pt"><SPAN
style="mso-spacerun: yes"> </SPAN><SPAN
style="mso-tab-count: 1"> </SPAN><SPAN
style="mso-spacerun: yes"> </SPAN></SPAN><SPAN
style="FONT-SIZE: 16pt"><A name=Check15></A></SPAN><SPAN
style="mso-bookmark: Check15"></SPAN></FONT></P></TD></TR>
<TR style="HEIGHT: 0.3in">
<TD
style="BORDER-RIGHT: #ece9d8; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 5.95in; PADDING-TOP: 0in; BORDER-BOTTOM: #ece9d8; HEIGHT: 0.3in; BACKGROUND-COLOR: transparent"
vAlign=top width=571>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt; tab-stops: .25in"><FONT
face="Times New Roman"><SPAN
style="mso-tab-count: 1"> </SPAN>If <B
style="mso-bidi-font-weight: normal">yes</B>, has a joint operating
agreement been signed? (<SPAN style="FONT-SIZE: 10pt">Documentation
required later.)</SPAN></FONT></P></TD>
<TD
style="BORDER-RIGHT: #ece9d8; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 1.1in; PADDING-TOP: 0in; BORDER-BOTTOM: #ece9d8; HEIGHT: 0.3in; BACKGROUND-COLOR: transparent"
vAlign=top width=106>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt; tab-stops: .25in"><FONT
face="Times New Roman"><SPAN style="FONT-SIZE: 16pt"><SPAN
style="mso-spacerun: yes"> </SPAN></SPAN><SPAN
style="FONT-SIZE: 16pt"><A name=Check16></A></SPAN><SPAN
style="mso-bookmark: Check16"></SPAN><SPAN style="FONT-SIZE: 16pt"><SPAN
style="mso-tab-count: 1"> </SPAN><SPAN
style="mso-spacerun: yes"> </SPAN></SPAN><SPAN
style="FONT-SIZE: 16pt"><A name=Check17></A></SPAN><SPAN
style="mso-bookmark: Check17"></SPAN><SPAN
style="FONT-SIZE: 16pt"><o:p></o:p></SPAN></FONT></P></TD></TR>
<TR style="HEIGHT: 0.3in">
<TD
style="BORDER-RIGHT: #ece9d8; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 5.95in; PADDING-TOP: 0in; BORDER-BOTTOM: #ece9d8; HEIGHT: 0.3in; BACKGROUND-COLOR: transparent"
vAlign=top width=571>
<P class=MsoNormal
style="MARGIN: 0in 0in 0pt 0.25in; tab-stops: .25in"><FONT
face="Times New Roman">Is the site </FONT><A name=Check28></A><SPAN
style="mso-bookmark: Check28"></SPAN><FONT face="Times New Roman"><SPAN
style="mso-spacerun: yes"> </SPAN>owned, </FONT><A
name=Check29></A><SPAN style="mso-bookmark: Check29"></SPAN><FONT
face="Times New Roman"><SPAN
style="mso-spacerun: yes"> </SPAN>optioned for purchase or </FONT><A
name=Check30></A><SPAN style="mso-bookmark: Check30"></SPAN><FONT
face="Times New Roman"><SPAN style="mso-spacerun: yes"> </SPAN>under
a lease of 5 years or more with renewal options?<SPAN
style="mso-spacerun: yes"> </SPAN><SPAN
style="FONT-SIZE: 10pt">(Documentation required later.)</SPAN><SPAN
style="mso-tab-count: 1"> </SPAN></FONT></P></TD>
<TD
style="BORDER-RIGHT: #ece9d8; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 1.1in; PADDING-TOP: 0in; BORDER-BOTTOM: #ece9d8; HEIGHT: 0.3in; BACKGROUND-COLOR: transparent"
vAlign=bottom width=106>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt; tab-stops: .25in"><FONT
face="Times New Roman"><SPAN style="FONT-SIZE: 16pt"><SPAN
style="mso-spacerun: yes"> </SPAN></SPAN><SPAN
style="FONT-SIZE: 16pt"><A name=Check18></A></SPAN><SPAN
style="mso-bookmark: Check18"></SPAN><SPAN style="FONT-SIZE: 16pt"><SPAN
style="mso-tab-count: 1"> </SPAN><SPAN
style="mso-spacerun: yes"> </SPAN></SPAN><SPAN
style="FONT-SIZE: 16pt"><A name=Check19></A></SPAN><SPAN
style="mso-bookmark: Check19"></SPAN><SPAN
style="FONT-SIZE: 16pt"><o:p></o:p></SPAN></FONT></P></TD></TR>
<TR style="HEIGHT: 0.3in">
<TD
style="BORDER-RIGHT: #ece9d8; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 5.95in; PADDING-TOP: 0in; BORDER-BOTTOM: #ece9d8; HEIGHT: 0.3in; BACKGROUND-COLOR: transparent"
vAlign=top width=571>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt; tab-stops: .25in"><FONT
face="Times New Roman">Has the applicant initiated a capital fundraising
campaign?</FONT></P></TD>
<TD
style="BORDER-RIGHT: #ece9d8; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 1.1in; PADDING-TOP: 0in; BORDER-BOTTOM: #ece9d8; HEIGHT: 0.3in; BACKGROUND-COLOR: transparent"
vAlign=top width=106>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt; tab-stops: .25in"><FONT
face="Times New Roman"><SPAN style="FONT-SIZE: 16pt"><SPAN
style="mso-spacerun: yes"> </SPAN></SPAN><SPAN
style="FONT-SIZE: 16pt"><A name=Check20></A></SPAN><SPAN
style="mso-bookmark: Check20"></SPAN><SPAN style="FONT-SIZE: 16pt"><SPAN
style="mso-tab-count: 1"> </SPAN><SPAN
style="mso-spacerun: yes"> </SPAN></SPAN><SPAN
style="FONT-SIZE: 16pt"><A name=Check21></A></SPAN><SPAN
style="mso-bookmark: Check21"></SPAN><SPAN
style="FONT-SIZE: 16pt"><o:p></o:p></SPAN></FONT></P></TD></TR>
<TR style="HEIGHT: 0.3in">
<TD
style="BORDER-RIGHT: #ece9d8; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 5.95in; PADDING-TOP: 0in; BORDER-BOTTOM: #ece9d8; HEIGHT: 0.3in; BACKGROUND-COLOR: transparent"
vAlign=top width=571>
<P class=MsoNormal
style="MARGIN: 0in 0in 0pt 0.25in; tab-stops: 9.0pt .25in"><FONT
face="Times New Roman">If <B style="mso-bidi-font-weight: normal">yes</B>,
what % of matching funds have been secured? <B
style="mso-bidi-font-weight: normal">_____________________</B></FONT></P></TD>
<TD
style="BORDER-RIGHT: #ece9d8; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 1.1in; PADDING-TOP: 0in; BORDER-BOTTOM: #ece9d8; HEIGHT: 0.3in; BACKGROUND-COLOR: transparent"
vAlign=top width=106>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt; tab-stops: .25in"><FONT
face="Times New Roman"> <SPAN
style="FONT-SIZE: 16pt"><o:p></o:p></SPAN></FONT></P></TD></TR>
<TR style="HEIGHT: 0.3in">
<TD
style="BORDER-RIGHT: #ece9d8; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 5.95in; PADDING-TOP: 0in; BORDER-BOTTOM: #ece9d8; HEIGHT: 0.3in; BACKGROUND-COLOR: transparent"
vAlign=top width=571>
<P class=MsoNormal
style="MARGIN: 0in 0in 0pt 0.25in; tab-stops: .25in"><FONT
face="Times New Roman">What other sources of matching funds are
available?</FONT></P>
<P class=MsoNormal
style="MARGIN: 0in 0in 0pt 0.25in; tab-stops: 9.0pt .25in"><B
style="mso-bidi-font-weight: normal"><FONT
face="Times New Roman">_______________________________________________________________</FONT></B></P></TD>
<TD
style="BORDER-RIGHT: #ece9d8; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 1.1in; PADDING-TOP: 0in; BORDER-BOTTOM: #ece9d8; HEIGHT: 0.3in; BACKGROUND-COLOR: transparent"
vAlign=top width=106>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt; tab-stops: .25in"><FONT
face="Times New Roman"> <SPAN
style="FONT-SIZE: 16pt"><o:p></o:p></SPAN></FONT></P></TD></TR>
<TR style="HEIGHT: 0.3in">
<TD
style="BORDER-RIGHT: #ece9d8; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 5.95in; PADDING-TOP: 0in; BORDER-BOTTOM: #ece9d8; HEIGHT: 0.3in; BACKGROUND-COLOR: transparent"
vAlign=top width=571>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt; tab-stops: .25in"><FONT
face="Times New Roman">Has the project received previous state
funding?</FONT></P></TD>
<TD
style="BORDER-RIGHT: #ece9d8; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 1.1in; PADDING-TOP: 0in; BORDER-BOTTOM: #ece9d8; HEIGHT: 0.3in; BACKGROUND-COLOR: transparent"
vAlign=top width=106>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt; tab-stops: .25in"><FONT
face="Times New Roman"><SPAN style="FONT-SIZE: 16pt"><SPAN
style="mso-spacerun: yes"> </SPAN></SPAN><SPAN
style="FONT-SIZE: 16pt"><A name=Check22></A></SPAN><SPAN
style="mso-bookmark: Check22"></SPAN><SPAN style="FONT-SIZE: 16pt"><SPAN
style="mso-tab-count: 1"> </SPAN><SPAN
style="mso-spacerun: yes"> </SPAN></SPAN><SPAN
style="FONT-SIZE: 16pt"><A name=Check23></A></SPAN><SPAN
style="mso-bookmark: Check23"></SPAN><SPAN
style="FONT-SIZE: 16pt"><o:p></o:p></SPAN></FONT></P></TD></TR>
<TR style="HEIGHT: 0.3in">
<TD
style="BORDER-RIGHT: #ece9d8; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 5.95in; PADDING-TOP: 0in; BORDER-BOTTOM: #ece9d8; HEIGHT: 0.3in; BACKGROUND-COLOR: transparent"
vAlign=top width=571>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt 0.25in"><FONT
face="Times New Roman">If <B style="mso-bidi-font-weight: normal">yes</B>,
detail dates, programs and amounts<SPAN
style="FONT-SIZE: 10pt">.</SPAN><U><SPAN
style="FONT-FAMILY: Arial"><o:p></o:p></SPAN></U></FONT></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt 0.25in"><FONT
face="Times New Roman"><B
style="mso-bidi-font-weight: normal">_______________________________________________________________</B><SPAN
style="FONT-FAMILY: Arial"><o:p></o:p></SPAN></FONT></P></TD>
<TD
style="BORDER-RIGHT: #ece9d8; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 1.1in; PADDING-TOP: 0in; BORDER-BOTTOM: #ece9d8; HEIGHT: 0.3in; BACKGROUND-COLOR: transparent"
vAlign=top width=106>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt; tab-stops: .25in"><FONT
face="Times New Roman"> <SPAN
style="FONT-SIZE: 16pt"><o:p></o:p></SPAN></FONT></P></TD></TR>
<TR style="HEIGHT: 0.3in">
<TD
style="BORDER-RIGHT: #ece9d8; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 5.95in; PADDING-TOP: 0in; BORDER-BOTTOM: #ece9d8; HEIGHT: 0.3in; BACKGROUND-COLOR: transparent"
vAlign=top width=571>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt"><FONT
face="Times New Roman">Has the project previously applied for and not
received state funding?</FONT></P></TD>
<TD
style="BORDER-RIGHT: #ece9d8; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 1.1in; PADDING-TOP: 0in; BORDER-BOTTOM: #ece9d8; HEIGHT: 0.3in; BACKGROUND-COLOR: transparent"
vAlign=top width=106>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt; tab-stops: .25in"><FONT
face="Times New Roman"><SPAN style="FONT-SIZE: 16pt"><SPAN
style="mso-spacerun: yes"> </SPAN></SPAN><SPAN
style="FONT-SIZE: 16pt"><A name=Check24></A></SPAN><SPAN
style="mso-bookmark: Check24"></SPAN><SPAN style="FONT-SIZE: 16pt"><SPAN
style="mso-tab-count: 1"> </SPAN><SPAN
style="mso-spacerun: yes"> </SPAN></SPAN><SPAN
style="FONT-SIZE: 16pt"><A name=Check25></A></SPAN><SPAN
style="mso-bookmark: Check25"></SPAN><SPAN
style="FONT-SIZE: 16pt"><o:p></o:p></SPAN></FONT></P></TD></TR>
<TR style="HEIGHT: 0.3in">
<TD
style="BORDER-RIGHT: #ece9d8; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 5.95in; PADDING-TOP: 0in; BORDER-BOTTOM: #ece9d8; HEIGHT: 0.3in; BACKGROUND-COLOR: transparent"
vAlign=top width=571>
<P class=MsoNormal
style="MARGIN: 0in 0in 0pt 0.25in; tab-stops: .25in"><FONT
face="Times New Roman">If <B style="mso-bidi-font-weight: normal">yes</B>,
detail dates, programs and amounts.<U><o:p></o:p></U></FONT></P>
<P class=MsoNormal
style="MARGIN: 0in 0in 0pt 0.25in; tab-stops: .25in"><FONT
face="Times New Roman"><B
style="mso-bidi-font-weight: normal">_______________________________________________________________</B><SPAN
style="FONT-FAMILY: Arial"><o:p></o:p></SPAN></FONT></P></TD>
<TD
style="BORDER-RIGHT: #ece9d8; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 1.1in; PADDING-TOP: 0in; BORDER-BOTTOM: #ece9d8; HEIGHT: 0.3in; BACKGROUND-COLOR: transparent"
vAlign=top width=106>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt; tab-stops: .25in"><FONT
face="Times New Roman"> <SPAN
style="FONT-SIZE: 16pt"><o:p></o:p></SPAN></FONT></P></TD></TR>
<TR style="HEIGHT: 0.3in">
<TD
style="BORDER-RIGHT: #ece9d8; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 5.95in; PADDING-TOP: 0in; BORDER-BOTTOM: #ece9d8; HEIGHT: 0.3in; BACKGROUND-COLOR: transparent"
vAlign=top width=571>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt; tab-stops: .25in"><FONT
face="Times New Roman">Is the project currently in application for or are
there plans to apply for other sources of state funding?</FONT></P></TD>
<TD
style="BORDER-RIGHT: #ece9d8; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 1.1in; PADDING-TOP: 0in; BORDER-BOTTOM: #ece9d8; HEIGHT: 0.3in; BACKGROUND-COLOR: transparent"
vAlign=top width=106>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt; tab-stops: .25in"><FONT
face="Times New Roman"><SPAN style="FONT-SIZE: 16pt"><SPAN
style="mso-spacerun: yes"> </SPAN></SPAN><SPAN
style="FONT-SIZE: 16pt"><A name=Check26></A></SPAN><SPAN
style="mso-bookmark: Check26"></SPAN><SPAN style="FONT-SIZE: 16pt"><SPAN
style="mso-tab-count: 1"> </SPAN><SPAN
style="mso-spacerun: yes"> </SPAN></SPAN><SPAN
style="FONT-SIZE: 16pt"><A name=Check27></A></SPAN><SPAN
style="mso-bookmark: Check27"></SPAN><SPAN
style="FONT-SIZE: 16pt"><o:p></o:p></SPAN></FONT></P></TD></TR>
<TR style="HEIGHT: 0.3in">
<TD
style="BORDER-RIGHT: #ece9d8; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 5.95in; PADDING-TOP: 0in; BORDER-BOTTOM: #ece9d8; HEIGHT: 0.3in; BACKGROUND-COLOR: transparent"
vAlign=top width=571>
<P class=MsoNormal
style="MARGIN: 0in 0in 0pt 0.25in; tab-stops: .25in"><FONT
face="Times New Roman">If <B style="mso-bidi-font-weight: normal">yes</B>,
detail dates, programs and amounts.<U><o:p></o:p></U></FONT></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt 0.25in; tab-stops: .25in"><B
style="mso-bidi-font-weight: normal"><FONT
face="Times New Roman">_______________________________________________________________</FONT></B><SPAN
style="FONT-FAMILY: Arial"><SPAN
style="mso-tab-count: 1">
</SPAN><o:p></o:p></SPAN></P></TD>
<TD
style="BORDER-RIGHT: #ece9d8; PADDING-RIGHT: 5.4pt; BORDER-TOP: #ece9d8; PADDING-LEFT: 5.4pt; PADDING-BOTTOM: 0in; BORDER-LEFT: #ece9d8; WIDTH: 1.1in; PADDING-TOP: 0in; BORDER-BOTTOM: #ece9d8; HEIGHT: 0.3in; BACKGROUND-COLOR: transparent"
vAlign=top width=106>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt; tab-stops: .25in"><FONT
face="Times New Roman"> <SPAN
style="FONT-SIZE: 16pt"><o:p></o:p></SPAN></FONT></P></TD></TR></TBODY></TABLE>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt 0.25in; tab-stops: .25in"><FONT
face="Times New Roman" size=3>If this will not be a completed project after the
requested state funding and matching funds are used, describe: (1) what the
project will be at the completion of the portion funded by this request and how
it will benefit the public; and (2) the phases and schedule for completion of
the project.</FONT></P>
<P class=MsoNormal
style="MARGIN: 6pt 0in 0pt 0.25in; LINE-HEIGHT: 150%; tab-stops: .25in"><U><SPAN
style="FONT-FAMILY: Arial; mso-bidi-font-family: 'Times New Roman'"><FONT
size=3><SPAN
style="mso-tab-count: 2">
</SPAN><SPAN
style="mso-tab-count: 2">
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style="mso-tab-count: 2">
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</SPAN><o:p></o:p></FONT></SPAN></U></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt 0.25in; tab-stops: .25in"><FONT
face="Times New Roman" size=3>What source(s) of nonstate funds exist for
completion of the project and its ongoing maintenance and operation?</FONT></P>
<P class=MsoNormal
style="MARGIN: 6pt 0in 0pt 0.25in; LINE-HEIGHT: 150%; tab-stops: .25in"><U><SPAN
style="FONT-FAMILY: Arial; mso-bidi-font-family: 'Times New Roman'"><FONT
size=3><SPAN
style="mso-tab-count: 2">
</SPAN><SPAN
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style="mso-tab-count: 2">
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</SPAN><SPAN
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</SPAN><SPAN style="mso-tab-count: 1">
</SPAN><o:p></o:p></FONT></SPAN></U></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt 0.25in; tab-stops: .25in"><FONT
face="Times New Roman" size=3>Legislative Sponsor</FONT></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt 0.25in; tab-stops: .25in"><FONT
face="Times New Roman"
size=3>(Signature)___________________________________________<SPAN
style="mso-tab-count: 1">
</SPAN>Date___________________</FONT></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt 0.25in; tab-stops: .25in"><FONT
size=3><FONT face="Times New Roman"> <o:p></o:p></FONT></FONT></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt 0.25in; tab-stops: .25in"><FONT
face="Times New Roman"><U><SPAN style="FONT-SIZE: 10pt">Note:</SPAN></U><SPAN
style="FONT-SIZE: 10pt"><SPAN style="mso-spacerun: yes"> </SPAN>This is
not a formal grant program.<SPAN style="mso-spacerun: yes"> </SPAN>This
form provides information for Members to request a separate appropriation in the
capital budget for this project.<SPAN style="mso-spacerun: yes">
</SPAN>Funding any project is at the discretion of the legislature. Successful
past projects generally are ones in which the requested state funds: (1) are
used for a facility providing an important public benefit; (2) are a small
portion of the total project funding (25% or less); (3) result in a completed
project or phase usable by the public for the intended purpose when the state
funds are expended; and (4) are for a project that is ready for construction or
renovation and will be completed within the biennium.
<o:p></o:p></SPAN></FONT></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt 0.25in; tab-stops: .25in"><SPAN
style="FONT-SIZE: 10pt"><FONT
face="Times New Roman"> <o:p></o:p></FONT></SPAN></P><SPAN
style="FONT-SIZE: 10pt; FONT-FAMILY: 'Times New Roman'; mso-fareast-font-family: 'Times New Roman'; mso-ansi-language: EN-US; mso-fareast-language: EN-US; mso-bidi-language: AR-SA">Please
note that projects may be subject to state prevailing wage law (Chapter 39.12
RCW).<SPAN style="mso-spacerun: yes"> </SPAN>Project sponsors are
encouraged to consult the Industrial Statistician (David Soma: 360-902-5330 or
somd235@lni.wa.gov) at the WA Dept of Labor Industries to determine whether
prevailing wages must be paid.<SPAN style="mso-spacerun: yes">
</SPAN>High-performance building requirements (Chapter 39.35D RCW) may also
apply.</SPAN></FONT></DIV>
<DIV><FONT face=Arial size=2></FONT> </DIV>
<DIV><FONT face=Arial size=2></FONT> </DIV>
<DIV><FONT face=Arial size=2>Regards,<BR>Keith Rutherford</FONT></DIV>
<DIV><FONT face=Arial size=2><A href="http://www.miracleleagueswwa.org"><IMG
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