Cover Sheet  (Word Doc)

                       South Dakota Preservation and Restoration

                                         Grant Application

 

 

Project: ____________________________________________      Date:_________________

 

 

Grant Application: _____ Building     _____ Memorial     _____ Landmark

 

Building (specify):

                                 _____ Interior     _____ Exterior     _____ Furnishings     _____ Collections

 

Memorial (specify work): ________________________________________________________________

 

Landmark (specify work): ________________________________________________________________

 

Organization Responsible for Project Completion (Organization to whom check should be written):

______________________________________________________________________________________

 (Note:  organization must have non-profit status as defined by Section 501(c)3 of the Internal Revenue Code.  The project site

cannot be privately owned.)

 

Primary Contact for that Organization:

 

Name ________________________________________________________________________________
 

Address ______________________________________________________________________________

 

Contact Information _____________________________________________________________________
                                     (Home phone, work phone and email, if available)
 

Project Dates:

Work to Begin on:___________________      Work to be Completed by:  _________________

 

Sponsoring Quester Chapter: ____________________________________________________________

 

Chapter P&R Liaison: _________________________________________________________________

 

Liaison Address_______________________________________________________________________

 

Liaison Contact Information_____________________________________________________________

                                                  (Home phone, work phone and email if available)
 

Other Sponsoring Chapters: ____________________________________________________________

 

State P&R Guidelines

Updated September 2008



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