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Form 1 <br />COVER SHEET <br />NAME OF ORGANIZATION: <br />NAME OF PROGRAM REQUESTING FUNDING: <br />CATEGORY OF NEED: Communitywide Event(s) <br />Cultural Arts <br />Special Program(s) <br />COMMUNITY BENEFIT FUNDS FROM CITY OF SAN LEANDRO: <br />Received FY 2006-07 Received FY 2007-08 <br />Request for FY 2008-09 <br />ORGANIZATION ADDRESS: <br />ORGANIZATION TELEPHONE NUMBER <br />ORGANIZATION FAX <br />PRIMARY CONTACT PERSON: <br />PRIMARY CONTACT TELPHONE NUMBER: <br />CONTACT E-MAIL ADDRESS: <br />EXECUTIVE DIRECTOR:(PRINT) <br />EXECUTIVE DIRECTOR TELEPHONE NUMBER: <br />EXECUTIVE DIRECTOR SIGNATURE: <br />PRESIDENT OF THE BOARD (PRINT) <br />PRESIDENT OF THE BOARD SIGNATURE <br />A. PROJECT SUMMARY: <br />B. The total number of anticipated residents expected to attend/participate in the proposed <br />prof ect/program. <br />C. ELIGIBILITY: I have reviewed the eligibility criteria explained in the RFP application and to <br />be the best of my knowledge: the funds requested from the City of San Leandro will be used to <br />provide the services described in this RFP. <br />Signed: <br />Date: <br />Executive Director <br />