Montana Cattlewomen, Inc. Application for Project Funding

MONTANA CATTLEWOMEN, INC.
APPLICATION FOR
2011-2012 EDUCATION/PROMOTION PROJECT FUNDING

Mail completed application to: MCW Secretary Missy Cox, 303 N. Front St., Townsend, MT 59644

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 anticipate reaching _________

6. Dollar amount being requested of the Montana CattleWomen: ______________________________
     Itemized budget for use of these Checkoff monies:______________________________________
    ________________________________________________________________________________
    ________________________________________________________________________________

7. What will your local be contributing to this program? (Include volunteer labor and time and mileage as well as other payment in kind and cash)     _______________________________________________
     _______________________________________________________________________________
     _______________________________________________________________________________

8. Do you have access to additional funding sources? ________________ Amount _______________

9. What are the goals for this program or project? __________________________________________
     __________________________________________________________________________________

10. How will you evaluate this program or project? __________________________________________
     _______________________________________________________________________________

11. Following the successful completion of this program, are you willing to share your program 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? _______________________________________________________________________________
________________________________________________________________________________

Person Completing Application ____________________________________ Date _____________
                                                                            (Please Sign)
Phone Number of person completing this application _____________________________________
E-mail of person completing this application_____________________________________________
Has your Montana CattleWomen, Inc. local paid their affiliation dues for 2012?__________________

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Recommendation of Steering Committee: _________________________________________________
Date: __________________________________________
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Note: The funding is Checkoff dollars from Montana beef producers.