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<DIV><FONT face=Arial size=2>Same email as before but sent from a Miracle League
email account.</FONT></DIV>
<DIV><FONT face=Arial size=2></FONT> </DIV>
<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'">2006 Member
Requested<o:p></o:p></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'">Local Community Project
Information Form<o:p></o:p></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'"> <o:p></o:p></SPAN></B></P>
<DIV>
<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">Project Name:
________________________________<o:p></o:p></B></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt; tab-stops: 217.5pt"><B
style="mso-bidi-font-weight: normal"> <o:p></o:p></B></P>
<P class=MsoNormal
style="MARGIN: 0in 0in 0pt; LINE-HEIGHT: 150%; tab-stops: .25in">Address
of Project Site:<SPAN style="mso-spacerun: yes"> </SPAN>_<B
style="mso-bidi-font-weight: normal">________________________<o:p></o:p></B></P>
<P class=MsoNormal
style="MARGIN: 0in 0in 0pt; LINE-HEIGHT: 150%; tab-stops: .25in"><SPAN
style="mso-spacerun: yes">
</SPAN>_<B
style="mso-bidi-font-weight: normal">________________________<o:p></o:p></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: 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">Legislative District: </B><U><SPAN
style="FONT-FAMILY: Arial">_____________</SPAN></U></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt"> <B
style="mso-bidi-font-weight: normal"><o:p></o:p></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: 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%"><B
style="mso-bidi-font-weight: normal">Project Contact</B><SPAN
style="mso-tab-count: 3">
</SPAN></P>
<P class=MsoNormal
style="MARGIN: 0in 0in 0pt; LINE-HEIGHT: 150%; tab-stops: .25in">Name(s)<SPAN
style="mso-spacerun: yes"> </SPAN><B
style="mso-bidi-font-weight: normal">_____________________________________</B></P>
<P class=MsoNormal
style="MARGIN: 0in 0in 0pt; LINE-HEIGHT: 150%; tab-stops: .25in">Title <B
style="mso-bidi-font-weight: normal"><SPAN
style="mso-spacerun: yes"> </SPAN>________________________________________</B></P>
<P class=MsoNormal
style="MARGIN: 0in 0in 0pt; LINE-HEIGHT: 150%; tab-stops: .25in">Organization<B
style="mso-bidi-font-weight: normal"><SPAN
style="mso-spacerun: yes">
</SPAN>_________________________________</B></P>
<P class=MsoNormal
style="MARGIN: 0in 0in 0pt; LINE-HEIGHT: 150%; tab-stops: .25in">Phone:<B
style="mso-bidi-font-weight: normal"> _________________</B><SPAN
style="mso-spacerun: yes"> </SPAN>Fax: <B
style="mso-bidi-font-weight: normal">________________</B></P>
<P class=MsoNormal
style="MARGIN: 0in 0in 0pt; LINE-HEIGHT: 150%; tab-stops: .25in">E-Mail:
<B
style="mso-bidi-font-weight: normal">______________________________________<o:p></o:p></B></P>
<P class=MsoNormal
style="MARGIN: 0in 0in 0pt; LINE-HEIGHT: 150%; tab-stops: .25in">Mailing
Address: ______<B
style="mso-bidi-font-weight: normal">________________________<o:p></o:p></B></P>
<P class=MsoNormal
style="MARGIN: 0in 0in 0pt; LINE-HEIGHT: 150%; tab-stops: .25in"><SPAN
style="mso-spacerun: yes">
</SPAN>______<B
style="mso-bidi-font-weight: normal">________________________<o:p></o:p></B></P>
<P class=MsoNormal
style="MARGIN: 0in 0in 0pt; tab-stops: .25in"> <U><o:p></o:p></U></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"><B
style="mso-bidi-font-weight: normal">Legislative Sponsor:</B><BR><B
style="mso-bidi-font-weight: normal">____________________________<o:p></o:p></B></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt 0.25in; tab-stops: .25in"><B
style="mso-bidi-font-weight: normal"> <o:p></o:p></B></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt 0.25in; tab-stops: .25in"><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></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt 0.25in; tab-stops: .25in"><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></P></TD></TR></TBODY></TABLE></DIV>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt; tab-stops: .25in"><B
style="mso-bidi-font-weight: normal">Project Information (attach separate page
with additional details if available):<o:p></o:p></B></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt 0.25in; tab-stops: .25in"><SPAN
style="mso-tab-count: 1"> </SPAN>Brief Project
Summary, including project location and the public benefit the project
provides:</P>
<P class=MsoNormal
style="MARGIN: 6pt 0in 0pt; LINE-HEIGHT: 150%; tab-stops: .25in"><U><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></U></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt 0.25in; tab-stops: .25in"><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></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt 0.25in; tab-stops: .25in"><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><SPAN
style="FONT-SIZE: 16pt"><SPAN
style="mso-spacerun: yes"> </SPAN></SPAN>Attachments<SPAN
style="mso-spacerun: yes"> </SPAN><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">
<o:p></o:p></B></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt 0.25in; tab-stops: .25in"><B
style="mso-bidi-font-weight: normal"> <o:p></o:p></B></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt; tab-stops: .25in"><B
style="mso-bidi-font-weight: normal">Eligible Project Type or Phase</B> <SPAN
style="FONT-SIZE: 10pt">(Check all that apply to this funding
request)</SPAN></P>
<DIV>
<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"> <o:p></o:p></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">% of Request</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"><SPAN style="FONT-SIZE: 16pt"><SPAN
style="mso-spacerun: yes"> </SPAN></SPAN>Land
acquisition</SPAN></P></TD><SPAN style="mso-bookmark: Text15"></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"><B
style="mso-bidi-font-weight: normal"><U><SPAN
style="mso-spacerun: yes">
</SPAN></U></B><U>%<o:p></o:p></U></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><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></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"><U><SPAN
style="mso-spacerun: yes">
</SPAN></U></B><U>%<o:p></o:p></U></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><SPAN style="FONT-SIZE: 16pt"><SPAN
style="mso-spacerun: yes"> </SPAN></SPAN>Design<SPAN
style="FONT-SIZE: 16pt"><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: 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"><U><SPAN
style="mso-spacerun: yes">
</SPAN></U></B><U>%<o:p></o:p></U></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><SPAN style="FONT-SIZE: 16pt"><SPAN
style="mso-spacerun: yes"> </SPAN></SPAN>New Construction<SPAN
style="FONT-SIZE: 16pt"><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: 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"><U><SPAN
style="mso-spacerun: yes">
</SPAN></U></B><U>%<o:p></o:p></U></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><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></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"><U><SPAN
style="mso-spacerun: yes">
</SPAN></U></B><U>%<o:p></o:p></U></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><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></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"><U><SPAN
style="mso-spacerun: yes">
</SPAN></U></B><U>%<o:p></o:p></U></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"><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: 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"><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></P></TD></TR></TBODY></TABLE></DIV>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt 0.25in; tab-stops: .25in"><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></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt; tab-stops: .25in"><B
style="mso-bidi-font-weight: normal">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></B></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt 0.25in; tab-stops: .25in"><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><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></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt 0.25in; tab-stops: .25in"><SPAN
style="FONT-SIZE: 16pt"><SPAN style="mso-tab-count: 1">
</SPAN></SPAN>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><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></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt 0.25in; tab-stops: .25in"><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><SPAN style="FONT-SIZE: 16pt"><SPAN
style="mso-tab-count: 1"> </SPAN></SPAN><SPAN
style="FONT-SIZE: 16pt"></SPAN></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">
<DIV><BR style="PAGE-BREAK-BEFORE: always" clear=all></DIV></SPAN></B>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt; tab-stops: .25in"><B
style="mso-bidi-font-weight: normal">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></B></P>
<DIV>
<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">Is this a
joint project?<SPAN style="mso-tab-count: 1">
</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"><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></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"><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></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"><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></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">Is
the site <A name=Check28></A><SPAN
style="mso-bookmark: Check28"></SPAN><SPAN
style="mso-spacerun: yes"> </SPAN>owned, <A name=Check29></A><SPAN
style="mso-bookmark: Check29"></SPAN><SPAN
style="mso-spacerun: yes"> </SPAN>optioned for purchase or <A
name=Check30></A><SPAN style="mso-bookmark: Check30"></SPAN><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></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"><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></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">Has the
applicant initiated a capital fundraising campaign?</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"><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></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">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></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"> <SPAN
style="FONT-SIZE: 16pt"><o:p></o:p></SPAN></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">What other sources of
matching funds are available?</P>
<P class=MsoNormal
style="MARGIN: 0in 0in 0pt 0.25in; tab-stops: 9.0pt .25in"><B
style="mso-bidi-font-weight: normal">_______________________________________________________________</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"> <SPAN
style="FONT-SIZE: 16pt"><o:p></o:p></SPAN></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">Has the
project received previous state funding?</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"><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></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">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></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt 0.25in"><B
style="mso-bidi-font-weight: normal">_______________________________________________________________</B><SPAN
style="FONT-FAMILY: Arial"><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"> <SPAN
style="FONT-SIZE: 16pt"><o:p></o:p></SPAN></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">Has the project previously
applied for and not received state funding?</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"><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></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">If
<B style="mso-bidi-font-weight: normal">yes</B>, detail dates, programs
and amounts.<U><o:p></o:p></U></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt 0.25in; tab-stops: .25in"><B
style="mso-bidi-font-weight: normal">_______________________________________________________________</B><SPAN
style="FONT-FAMILY: Arial"><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"> <SPAN
style="FONT-SIZE: 16pt"><o:p></o:p></SPAN></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">Is the
project currently in application for or are there plans to apply for other
sources of state funding?</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"><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></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">If
<B style="mso-bidi-font-weight: normal">yes</B>, detail dates, programs
and amounts.<U><o:p></o:p></U></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt 0.25in; tab-stops: .25in"><B
style="mso-bidi-font-weight: normal">_______________________________________________________________</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"> <SPAN
style="FONT-SIZE: 16pt"><o:p></o:p></SPAN></P></TD></TR></TBODY></TABLE></DIV>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt 0.25in; tab-stops: .25in">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.</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'"><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><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><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><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: 1">
</SPAN><o:p></o:p></SPAN></U></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt 0.25in; tab-stops: .25in">What
source(s) of nonstate funds exist for completion of the project and its ongoing
maintenance and operation?</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'"><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">
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<P class=MsoNormal
style="MARGIN: 0in 0in 0pt 0.25in; tab-stops: .25in">Legislative Sponsor</P>
<P class=MsoNormal
style="MARGIN: 0in 0in 0pt 0.25in; tab-stops: .25in">(Signature)___________________________________________<SPAN
style="mso-tab-count: 1">
</SPAN>Date___________________</P>
<P class=MsoNormal
style="MARGIN: 0in 0in 0pt 0.25in; tab-stops: .25in"> <o:p></o:p></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt 0.25in; tab-stops: .25in"><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></P>
<P class=MsoNormal style="MARGIN: 0in 0in 0pt 0.25in; tab-stops: .25in"><SPAN
style="FONT-SIZE: 10pt"> <o:p></o:p></SPAN></P>
<DIV><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></DIV>
<DIV><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"></SPAN> </DIV>
<DIV><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"></SPAN> </DIV>
<DIV><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">Regards,</SPAN></DIV>
<DIV><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">Keith
Rutherford, VP</SPAN></DIV>
<DIV><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">Miracle
League of Southwest Washington</SPAN></DIV>
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href="http://www.miracleleagueswwa.org"><IMG alt="" hspace=0
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