Wufoo
2014 Hotel/Motel Tax Grant Application
Please complete the following questions as completely as possible. Submit by 5 pm, Tuesday, November 12, 2013.
Organization Information
Project/Event Title
*
Name
*
First
Last
Address
*
Street Address
Address Line 2
City
State / Province / Region
Postal / Zip Code
United States
United Kingdom
Australia
Canada
France
New Zealand
India
Brazil
----
Afghanistan
Åland Islands
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Colombia
Comoros
Democratic Republic of the Congo
Republic of the Congo
Cook Islands
Costa Rica
Côte d'Ivoire
Croatia
Cuba
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
East Timor
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Faroe Islands
Fiji
Finland
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Grenada
Guatemala
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Mauritania
Mauritius
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
Curacao
Nicaragua
Niger
Nigeria
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Poland
Portugal
Puerto Rico
Qatar
Romania
Russia
Rwanda
Saint Kitts and Nevis
Saint Lucia
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
Spain
Sri Lanka
Sudan
Suriname
Swaziland
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Togo
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Tuvalu
Uganda
Ukraine
United Arab Emirates
United States Minor Outlying Islands
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
Virgin Islands, British
Virgin Islands, U.S.
Yemen
Zambia
Zimbabwe
Country
Phone Number
*
###
-
###
-
####
Federal I.D. number of the organization
*
State whether the applicant is controlled, supervised, operated by or in connection with another organization, or if it is the outgrowth of another organization.
*
History and description of the program and goals.
*
Names and addresses of the Board of Directors, board members associated with/employed by the organization and documentation that the board authorized the application
*
Names, titles, duties and qualifications of volunteers and/or staff responsible for project implementation
*
A copy of the Treasury letter certifying tax-exempt status as an organization that is not a private foundation and a copy of the organization’s most recent Form 990 – Income Tax Return of Organization Exempt for Income Tax
*
Project Details
Provide project/event dates, times, location, duration and a complete statement of the purpose of the grant
*
Amount requested
*
Project Description & Background
Is the request for a one-time special project or new activity, or operating support for an existing program or event?
*
One-time special project
New activity
Operating support for an existing program or event
What are the short and long-term goals of the project? Coordination – Who is taking the lead on this project? What other organizations are working on the project/event? How will coordination be accomplished? Evaluation – By what criteria will the success or failure of the project/event be measured?
*
Budget/Financials
What is the total cost of the project? Specifically, how will the money be used? When will the money be needed? Support – What other sources of financial support are committed or are being sought for the project? Organizations and amounts should be listed. Future Support – Will the project continue beyond the funding period? If so, how will it be supported? If the program is to be sustained, provide plans for permanent support after the City’s funding has been terminated. Maintenance Costs – What are the projections for short-term and long-terms costs to maintain this project?
*
Visitors/Overnight Stays in Dublin Hotels
Attendance – What is the expected spectator attendance? What is the expected participant attendance? What are the attendance records for the last two years? Overnight Visitors – How many overnight visitors are estimated? What is the basis for estimates? How will you promote Dublin hotels? Please provide number of overnight stays from last year’s and/or previous year’s events with the input of the Dublin Convention and Visitors Bureau – 614.792.7666.
*
Community Impact/Promotion/Outreach
How will the Dublin community benefit from your project or event? How will your organization benefit from your project or event? How will you promote/recognize the City of Dublin’s support? Are there ceremonial and/or other opportunities or engagement for the City of Dublin and/or the Dublin community during your event or project? How will the project/event be promoted within Dublin and beyond Dublin?
*
City Services/Support
City Services – What City of Dublin services are required to implement the project/event? What is the cost of these services? Have these services been coordinated with the Division of Event Administration? Has the organization applied for an Event Permit?
*
Optional Additional Information
Letters of support, articles or data relating to the project may be uploaded to your application
Do Not Fill This Out