First Name
*
Last Name
*
E-mail
*
Mobile Phone
*
Street Address
*
City
*
State/Province
*
ex: AB, ON, PE
Zip Code/Postal Code
*
123ABC or 123 ABC
Company/Organization
*
How did you find out about KOMPAN Matched Funding?
*
KOMPAN Website
Email Newsletter
Facebook
LinkedIn
Search Engine
Have you ever worked with Kompan before?
*
Yes
No
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?
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Yes
No
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. (10 MB limit. Please check attachment size if you receive an error when submitting.)
Additional Attachment
Additional Attachment
Additional Attachment
I have read and agree to the
Terms and Conditions
.
*
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