Applicant Sponsor Contact Information Form
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1APPLICANT SPONSOR CONTACT INFORMATION:
Sponsor Agency (Governmental Agency):
Parish (of recreational site):
Appointed Authority Name & Title (Parish President, Mayor, etc.):
Agency Address:
Phone:
Fax:
Email:
Website Address:
Alternate Name & Email:
Co Sponsor Agency (Recreation District, School Board, or agency; if applicable):
Appointed Authority Name & Title: (President, Director, etc.)
Agency Address:
Phone:
Fax:
Email:
Website Address:
Alternate Name & Email:
PROJECT NAME (same as on application):
Applicant Author (Project Manager, Design Professional) Contact Information:
Name & Title:
Phone:
Email:
Website Address:
Park or Project Involvement (name of park & project that you are applying for LWCF grant
funding delete this note):
OFFICE OF STATE PARKS NOTES:
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