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Account Name Past Actual 3 Past Actual 2 Past Actual 1 Projected <br />Speaker Fees $1000.00 $1000.00 $0.00 $1500.00 <br />Entertainment $0.00 $0.00 $0.00 $500.00 <br />Program Printing $1500.00 $1847.00 $0.00 $2500.00 <br />Supplies $675.00 $430.00 $0.00 $750.00 <br />Ticket Selling Fees $300.00 $300.00 $0.00 $300.00 <br />Catering and Venue $0.00 $4000.00 $0.00 $5000.00 <br />Rental <br />Hospitality $500.00 $500.00 $0.00 $500.00 <br />Mailing Costs $0.00 $0.00 $0.00 $200.00 <br />Design $0.00 $0.00 $0.00 $1500.00 <br />Past Actual 3 Past Actual 2 Past Actual 1 Projected <br />Expense Totals $20975.00 $16977.00 $0.00 $30350.00 <br />Profit &Loss <br />Past Actual 3 Past Actual 2 Past Actual 1 Projected <br />$-6725.00 $-267.00 $0.00 $33678.32 <br />Application Certification <br />The applicant here certifies and affirms:1.That it does not now,nor will it during the performance of any contract arising <br />from this application,unlawfully discriminate against any employee,applicant for employment,client,customer,or other <br />person who might benefit from said contract,by reason of age,race,color,ethnicity,sex,religion,military status,sexual <br />orientation,creed,place of birth,or disability;2.That it will abide by all relevant local,state and federal laws and <br />regulations and;3.That it has read the information contained in the Instructions on pages 1 and 2 and understands and <br />will comply with all provisions thereof. <br />Certified by:Sign <br />Name*Jill Scheffer <br />Applicant's Title *President