APPLICATION
FOR
2011-2012 CROCK OF BEEF FUNDING
Mail completed application to: Kae McCloy, 2394 Fly Crk Rd., Pompeys
Pillar, MT 59064
1. Date application
submitted:________________________________________________
2. Name of Local requesting
funds:____________________________________________
3. Name and address of contact
person________________________________________
________________________________________________________________________
4. Title of Program or
activity:_________________________________________________
5. Date of activity:_______________Number of people
you plan to reach:______________
6. Dollar amount being requested of the Montana
CattleWomen:_____________________
Itemized budget for use of these Check-off dollars:
________________________________________________________________________
________________________________________________________________________
7. Do you have access to additional funding sources?
_______________Amount:_______
8. What will your local be contributing? (Include
volunteer labor, time, mileage, as well as
other payment in kind and
cash)____________________________________________
________________________________________________________________________
________________________________________________________________________
9. What are the goals for this program or
project?___________________________
10. How will you evaluate this program or
project?__________________________________
11. Following the program, will you share your
success with other locals?_______________
12 Number of members in your local?__________How many
are MCW members?_______
13. Do you agree to submit a written evaluation
(including documentation for the Beef Council) of your
program and copies
of receipts for reimbursement within two weeks of completion of
program?_________________________________________________
14. Person Completing
Application_______________________________Date__________
(Please Sign)
Recommendation of COB
Committee:________________________Date:__________________
Note: Part of the funds are made from Check-Off funds from Montana Beef
producers.