(CID) Fund Application - District 2 | Supervisor John Tavaglione

COMMUNITY IMPROVEMENT DESIGNATION
FUND APPLICATION
COUNTY OF RIVERSIDE – SECOND DISTRICT
JULY 1, 2014—JUNE 30, 2015
Second District Rules for CID Applications
Please read the following before filling out an application
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CID applications are classified as a public record, and may be subject to requests for copies by the media, the
public, or any other interested parties.
Every CID application is considered individually and on its own merit.
Preference for CID awards will be given to organizations and activities that directly benefit the residents of the
Second District.
CID recipients are not permitted to do the following:
- Use the Supervisor’s name in promotion of their events or activities unless otherwise specifically
authorized by this office.
- Recognize a particular Supervisor; any recognition is to be made to the Riverside County Board of
Supervisors or the County of Riverside.
- Provide plaques, banners, or other recognition of funding or sponsorship during or after the event.
The awarding of CID funds does not constitute an automatic annual allocation.
CID funds must be spent as specified on the application, and records may be requested by the Board of
Supervisors, the County Auditor, or other appropriate agencies to ensure the funds were used appropriately.
Grant applications must be submitted to the Supervisor’s office no later than 6 weeks before the payment is
needed.
CID grants will not be awarded or announced by this office within the 60 days before an election in which the
Second District Supervisor is on the ballot.
Page 1 of 4
CID Fund Application – FY14/15
Supervisor John Tavaglione – Riverside County, Second District
(Please print or type)
GENERAL INFORMATION
Name of Organization:
Event
Project
Other
CID Fund Request is for:
(Choose one)
Event/Project Name:
Event Date:
Amount Requested from Second District: $
If yes, please indicate the following:
Are you requesting CID funds from
another Supervisor’s office?
YES
NO
District:
Amount Requested: $
Event/Project Name:
Event Date:
ORGANIZATIONAL DATA
Contact Name:
Title/Position:
Telephone:
Email Address:
Mailing Address:
Area(s) Served:
Type of Organization:
Non Profit
Interested in being spotlighted on our website?
Community Organization
Government Agency
YES
NO
Other, Please explain:
Page 2 of 4
CID Fund Application – FY14/15
Supervisor John Tavaglione – Riverside County, Second District
MISSION STATEMENT
Describe the goals and objectives of your organization:
PROJECT DESCRIPTION
How will your organization use the funding awarded? Describe the project and the project objectives.
Explain how the funding/project benefits the constituents of the Second District.
Page 3 of 4
CID Fund Application – FY14/15
Supervisor John Tavaglione – Riverside County, Second District
CHECK INFORMATION
Title of Organization/Event as required on the check:
Check Mailing Address:
CONTACT INFORMATION
APPLICATION SUBMISSION
If you have any questions , please contact:
Please mail, email, or deliver the application to:
Name: Karen Christensen
Title: Deputy Chief of Staff - Supervisor Tavaglione
Office: 951-955-1021
Fax: 951-955-2362
Email: [email protected]
Supervisor John Tavaglione
Riverside County, Second District
Attn: Karen Christensen
4080 Lemon Street, 5th Floor
Riverside, CA 92501
Email: [email protected]
SIGNATORY
I hereby certify the information contained in this application is true to the best of our knowledge and belief,
and that we will abide by the rules related to receiving CID funds.
Name:
Title/Position:
Signature:
Date:
Telephone Number:
Email Address:
Page 4 of 4
CID Fund Application – FY14/15
Supervisor John Tavaglione – Riverside County, Second District

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