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9129122, 10t49 AM LTAC Clerk Review Erhibit'S <br />CLTAC: Clerk Application Review <br />Current Year Grant <br />Application <br />Workshop* <br />Organization <br />Address * <br />Upload Proof of <br />Organization Status* <br />Street Address <br />PO Box 916 <br />Address Line 2 <br />City <br />Cle Elum <br />Postal / Zip Code <br />98922 <br />IRS Determination Letter.pdf <br />Acceptable file formats include: JPG, PDF or TIFF <br />Did you altend the Grant Application Workshop for the current year hosted by the Kittitas Counly Chamber of <br />Commerce? <br />Yes <br />No <br />Clerk Verification *Please conflrm whether the applicant attended the workshop or not. <br />No <br />Organ ization I nformation <br />Name of Roslyn Ronald Cle Elum Heritage Club <br />Organization * <br />Organization is a:* Business <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 />64KB <br />Project Contact Information <br />First Name*Maria <br />lf-app-16-03.co.kittilas.wa.us/Forms/formlsubmission/history/77854/85641?hideHeader=true 1t17