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9129122, 11 :10 AM LTAC Clerk Review Ernrbrt /r\ <br />R <br />CLTAC: Clerk Application Review <br />Current Year Grant <br />Application <br />Workshop* <br />Name of <br />Organization * <br />Organization <br />Address* <br />Upload Proof of <br />Organization Status* <br />Street Address <br />901 E 7th Ave, Suite 1 <br />Address Line 2 <br />Suite'1 <br />City <br />Ellensburg <br />Postal / Zip Code <br />98926 <br />2021 W-9 signed.pdf <br />Acceptable file formats include: JPG, PDF or TIFF, <br />State / Province / Region <br />Washington <br />Country <br />United States <br />1 38.1 BKB <br />Did you attend the Grant Application Workshop for the current year hosted by the Kittitas County Chamber of <br />Commerce? <br />Kittitas Valley Event Center <br />Yes <br />No <br />Clerk Verification *Please confirm whether the applicant attended the workshop or not. <br />Yes <br />No <br />Organ ization I nformation <br />Organization is a:*Business <br />Non-Profit <br />(Note: Please submit w-9 for business or IRS Designation Letter for non-profit.) <br />Click here to view sample documents (redacted). <br />Project Contact I nformation <br />First Name*Kady <br />lf-app-16-03.co.kittitas.wa.us/Forms/form/submission/history/776O2t85647?hideHeader=true 1t14