Application

Western Regional Economic Zone Coalition Funding Application

Thank you for your interest in applying for funds to help improve the environment throughout the Western Regional Economic Zone. Please answer the following questions and when finished, click submit. Your responses will be automatically sent to the decision-making committee regarding your request. If you have further questions or comments, please contact Frank Scarpino at Frank.Scarpinato@erie.gov (For Erie and Niagara Counties) or Brittani Dallas at bdallas@alleganycouncil.org (for Allegany, Chautauqua, or Cattaraugus Counties).

Coalition Name *

Is your coalition a 501(c)(3)? *

Yes No

If "No," who is your affiliate 501(c)(3)? (A School May be Used) *

Please Provide the Federal Tax ID of your Coalition or Affiliated 501(C)(3) (A school may be used) *

What is the name of your project? *

What is the cost of your project? *

What is the start date of your project? *

What is the end date of your project? *

Please describe your project (please include a simple budget). *

What are the expected results of this project? What will change? *

Your Name *

Your E-mail *

Phone Number *

Date *

Submit

If your project is funded, an additional requirement is to create some sort of media noting that the event was sponsored by the "Western Regional Addiction Resource Collaborative" and containing the following logo:

You can download the logo here.
The media can be a direct mailer, an e-mail to interested parties, an announcement, a flyer etc. You will be required to submit at least one form of proof of performance containing the media and logo upon completion of the project.

Western Regional Economic Zone Coalition Funding Application

Services

Suggestions

Western Regional Economic Zone Coalition Funding Application​

Services

Suggestions

Western Regional Economic Zone Coalition Funding Application