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LTAC Clerk Review F*h\bir N.9129122, 12:24 PM <br />CLTAC: Clerk Application Review <br />Clerk Verification *Please confirm whether the applicant attended the workshop or not. <br />Yes <br />:: NO <br />Organ ization I nformation <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 />6181 Wilson Creek Rd <br />Address Line 2 <br />City <br />Ellensburg <br />Postal / Zip Code <br />98926 <br />Business_Lic_w_DBA. pdf <br />Acceptable file formats include: JPG, PDF or TIFF <br />Did you attend the Grant Application Workshop for the current year hosted by the Kittitas County Chamber of <br />Commerce? <br />Yes <br />No <br />The Patch at Jensen Farms <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 />State / Province / Region <br />WA <br />Country <br />United States <br />862.7KB <br />Project Contact I nformation <br />First Name*Hilary <br />lf-app-16-03.co.kittitas.wa.us/Forms/form/submission/history/77621l86050?hideHeader=true 1t14