WEEB 1 (Rev. 6/06 ) Check one box that best 
describes your project:		 Mini grant?

Mail original proposal and 5 copies to:
Cover Page o General EE

o Forestry Education

 o School Forest

 o  School Forest Education Plan		 o  Yes

 o  No

WISCONSIN ENVIRONMENTAL EDUCATION BOARD
110B College of Natural Resources 
University of Wisconsin - Stevens Point
800 Reserve Street
 Stevens Point, WI 54481-3897

  GENERAL INFORMATION

 

Administering Organization

              

Mailing Address (Street, City, State, Zip)

         

Eligibility: Corporation (nonstock, nonprofit) or public agency (check appropriate box)
¨ Conservation organization                ¨ "Friends" group         ¨ Nature Center/Museum/Zoo       ¨ Labor Union
¨ Professional association                   ¨ Youth Organization        ¨ Service Club       ¨ CESA
¨ Municipal Government                    ¨ Lake district                                         ¨ School District                        ¨ Cooperative Extension
¨State Agency                                  ¨ Tribal Government                                ¨ College/University                   ¨ Other (Specify) ___________________

Project Director/Contact Person
   

Daytime telephone area code/number

    

Fax area code/number

    

Email

Mailing Address (if different from above) Street, City, State, Zip

              

If different addresses, send mail to:

     ¨   Admin. Organization ¨Project Director

Project Title

              

What EE2010 goal does the project address?  Select one.

 

¨I                   ¨II           ¨III            ¨IV   ¨V            ¨VI 

 

       Grant Request               $          

 

       Matching Funds             $          

 

       Percent Match:                         % (25% minimum)

 

       Projected Start Date                                              

 

       Projected End Date                                                 

WI Legislative Assembly District(s):

    

WI Legislative Senate District(s):

    

Wisconsin Nonprofit Corporation Number or LEA ID No.

                

 

          CERTIFICATION

 

If this project is approved, the undersigned certifies that the organization will participate as indicated in the narrative and will provide the matching dollars by cash, services, or in-kind contributions between July 1, 2007 and December 31, 2008. None of these grant funds will be used to supplant existing funding.

Project Director

 

Signature                         
Ø   

Title
      

Date signed

      

Primary Grant Writer
 

Signature                         
Ø                

Title
      

Date signed

      

Chief Executive Officer

 

Signature

Ø                

Title

            

Date signed

      

 

             ABSTRACT

Limit to space provided.

 

 

.