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Name of the non-profit organization Contact Name First Last Email Address Project/Program Title Brief Description of the Project/Program Total Funding Requested: Budget Breakdown of Requested Funds Attestation and Signature I agree to submit annual reporting on how the funds were used with copies of receipts or applicable information. I certify that my answers are true and complete to the best of my knowledge. Date: Signature: Return application to: or email: Laurie Whalen [EMAIL REDACTED] Dawson County Finance Dept 25 Justice Way; Suite 2214 Dawsonville, GA 30534 I understand that false or misleading information in my application or documentation may result in prosecution and repayment of funds. (attach as additional page if needed) (attach as additional page if needed) Application deadline is: April 11, 2025