MMIA Risk Management Training Endowment Application

MMIA Risk Management Training Endowment Application
Project Title/Name:
Date of Event

Month Day Year Date Picker Icon
Municipal Sponsor: (city, town, department)
Primary Contact
Primary Contact:

First Name Last Name
E-mail
Phone Number

Area Code Phone Number

Mailing Address

Mailing Address 1
Mailing Address 2
City	State / Province
Postal / Zip Code

Abstract/Summary: (2-3 sentences that describe your project)
Participating Municipalities (Registration must include 10% of MMIA’s Member Entities)
Budget:
Overall Project Budget:
Total Request of the MMIA Endowment: (up to $2,000)
Endowment Request as Percentage of Total Budget:
Should be Empty: