Otsego Wildlife Legacy Society - Otsego County, MI

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Grant Application Form

Date of Request:

Name of Organization making request:

Coordinator:

Postion:

Street Address:

City:

State:

Zip code:

Phone:

Email:

Title of Project:

Description of Project:

Permits Required: *

Yes

No

If yes, what date did you apply for the permits? What date did you recieve the permits?

Allocation $ Requested:

Are any other organizations or individuals contributing to this project?:

If yes, who? Amount?

Budget & Materials Description:

Annual Cost of Project:

Starting Date:

Completion Date:

Comments:

Thanks for submitting!

Feel free to contact us any time if you have questions!

Thanks for submitting!

PO Box 543

Gaylord, Michigan

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