2.	APPLICATION:

Mount Tabor Preservation Fund
Grant Application Form


Applicant’s Name: ________________________________________________
								
Organization’s Name: ________________________________________________
(If applying on behalf of an organization)

Contact Address:  ________________________________________________

Phone Number: ________________________________________________									

Fax Number: ________________________________________________
									
Email Address: ________________________________________________
								
Resource’s Physical Address: ________________________________________________						
(If different than above)

Historic Name of Resource: ________________________________________________							
(Ex. The Tabernacle)

Construction Date of Historic Resource:	________________________________________________					

Brief Description of the Proposed Project*

										

										


Total Project Budget: ________________________________________________								

Award Amount Requested:	________________________________________________						


If awarded a grant from the Mount Tabor Preservation Fund, the applicant agrees to complete the project within a year 
of grant notification (unless granted an extension by the MTPF). Applicants who have been awarded grants must 
present the MTPF committee completed work invoices before being reimbursed the awarded project amount.

The Mount Tabor Preservation Fund, reserves the right to publicize the names and locations of the grant recipients 
as well as publicize photographs of the properties.

The following homeowner(s) agree to the terms mentioned above.


______________________________________          ___________________________												
Applicant Signature				Date


______________________________________          ___________________________											
Co-Owner of Property				Date

* NOTE: Proposal Letter is also required see “How to Apply”