Jasper County Development District #1


Funding Request


Application Date:___/___/___


Applicant Name:__________________________________________________


Applicant Address:________________________________________________


Applicant City:___________________________ State:______ Zip:_________


Applicant Phone (____)____-_____ Fax(____)____-_____


Contact Person:__________________________________________________


Tax ID Number:_______________________________________


Purpose of your Organization or Event:

_______________________________________________________________

_______________________________________________________________

_______________________________________________________________


Date(s) of your Event:_____________________________________________


Primary Location for the Event or Organization:_________________________

_______________________________________________________________


Amount Requested:$____________________


How will this amount be used:______________________________________

______________________________________________________________

______________________________________________________________


Primary Purpose of the activity/organization:__________________________

______________________________________________________________

How this activity/organization will provide Tourism Development within the District:

______________________________________________________________

______________________________________________________________


Total Cost of the activity/organization:$__________________

Comments:____________________________________________________

_____________________________________________________________

_____________________________________________________________


By submitting your application to the District you acknowledge that funds requested are being used within the Laws of the State of Texas. You also acknowledge that failure to use the funds as required by Law, you will be subject to prosecution to recover such funds. You also acknowledge that if your event/organization is canceled or dissolved, all funds UNLESS specifically agreed to in writing will be returned to the District.



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Applicant’s Printed Name Date

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Applicant’s Signed Name