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EXHIBIT "A" <br />CLTAC: Application for Lodging Tax Grant Funding <br />Grant Application did you attend the Grant Application Workshop - 2017 hosted by the Kttitas County Chamber of Commerce? <br />Workshop - 2017 * a Yes <br />C� No <br />Submittal Instructions C Yes, <br />& General I have read and understand Submittal Instructions and General Information for the 2017 Lodging Tax Grant Funding <br />Information * Frocess <br />Y Q 1 I A r q s i r r, rr 11 y, rmla talres i tis l ir, Rf�P ' a �nn�► amps r ti a �' �k �l ru 11 �nsr, u:Y. b'� af'IIs; furl M Wmt'ih" .7 400 0 tap:4V <br />C d i tc r , r I cl s, ivr v.; f; "t nsr;ii tq'IICattfh n flra )i ;V3. 9ii411, 411Vor '0 ti^om � Af' rrov, <br />I' ialll, iI.i b0l's�,f'[ itlQd4fl(�i f7`�'�if<<Vl���li ''n t1lfluv(il yoml "'4.n 01K.y ilp4 <br />l�: : � I, tihi.l'i p�o)I� rl�'Ih tPf,c3L3�,� �;wa (�11�e��;�h ,�IrVi 7�GaGS�• iQl t �SjIiQhL'55 :dtir=1��„I If,'��55VyTSmn�iN�r�'r,c>0 CRpdfalf'�I�GII�I�t i�p1'��',1Vi. �KiIPri:J�l� �(�)"�'[ NnI��J(C <br />-SII -r_ • It: �.1 t� ' aanr i��il!gl a�rti ie c ntp ,iiirt{i�D .;fim :•� �s g; t"r * .t � '1al UIV wg mcut41var+kr 8i!irl�, <br />111 • F :: I ; I;- : l');�, sr;�gmitl:i'1z. S�%a¢aRir illir s"iU� �tV��j� <br />Organization Information <br />Name of Organization* Junk-tiquen in the Burg - Becky Sherley <br />Organization Address* Street Address <br />2830 S. Thorp MM' <br />Address Line 2 <br />City <br />Ellensburg <br />Fbstal / Zip Code <br />98926 <br />Website wvvw.junk-tiquenintheburg.com <br />Federal Tax ID #* 00-0000000 <br />State / F rovince / P--gion <br />WA <br />Country <br />USA <br />UBI#* 000-000-000 <br />Organization is a: * O Government Entity <br />O 501(c)3 <br />C 501(c)4 <br />d 501(c)6 <br />M Other Ilndividual <br />(Note: you must submit 501(c)3, 501(c)4, or 501(c)6 approval documentation.) <br />Click here to view sample documents (redacted). <br />Upload Proof of proof of organizational status.pdf <br />Organization Status* Acceptable file formats include: JFG,PDF orlFF. <br />Contact Information <br />First Name* Becky <br />Last Name* Sherley <br />89.8KB <br />