First Name*
 
 
 
 
 
 
Last Name*
 
 
 
 
 
 
E-mail*
 
 
 
 
 
 
Mobile Phone*
 
 
 
 
 
 
Street Address*
 
 
 
 
 
 
City*
 
 
 
 
 
 
State/Province*
 
 
 
ex: NY, TX, WA
 
 
Zip Code/Postal Code*
 
 
 
12345 or 12345-6789
 
 
Company/Organization*
 
 
 
 
 
 
How did you find out about KOMPAN Matched Funding?*
 
 
 
 
 
 
Have you ever worked with Kompan before?*
 
 
 
 
 
 
Provide a description of your organization and their mission:*
 
 
 
 
 
 
Please describe the community you serve:*
 
 
 
 
 
 
Provide a description of the playground or fitness space site:*
 
 
 
 
 
 
Do you have an existing playground in this space?*
 
 
 
 
 
 
What's the anticipated usage of the site? (ie ages and quantity of children)?*
 
 
 
 
 
 
What do you hope to accomplish with the new playground or fitness area?*
 
 
 
 
 
 
How is your community supporting this project?*
 
 
 
 
 
 
Please provide any additional video, presentations or photos that tell us why you should be awarded this grant.
 
 
 
 
Additional Attachment (10 MB LIMIT)
 
 
 
 
 
 
Additional Attachment (10 MB LIMIT)
 
 
 
 
 
 
Additional Attachment (10 MB LIMIT)
 
 
 
 
 
 
I have read and agree to the Terms and Conditions.*
 
 
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