Request Funding - M.E.A.D.A

FUNDING REQUIREMENTS

Submit 60 days prior to needing funds
Ensure project addresses youth drug awareness or prevention
Ensure project addresses the needs of the Wright County community

If funded, credit MEADA on project materials and submit a Grant Follow-Up Form

GRANT REQUEST FORM

TODAY'S DATE

ORGANIZATION

NAME

PHONE

PROJECT TITLE

PROJECT DESRIPTION

how does this project address youth substance use?

how does this project address the needs of the Wright County community?

ESTIMATED REACH of project

AMOUNT REQUESTED (up to $500)

PROJECT DATE(S)

funds needed by

acknowledgement:

I acknowledge that my organization can receive a maximum of $500 per calendar year. I acknowledge that meada only reviews grant requests at their bimonthly meeting on the second wednesday of even months and grants with a . I acknowledge that, if funded, my organization must complete a follow-up form and that failure to do so may result in denial of future funding requests.

ADDITIONAL COMMENTS

MAKE AWARD CHECK PAYABLE TO

MAIL AWARD CHECK TO