Name of Lookout Project:__________________________________________________________

Location (State, County, Township, Legal, Lat/Long, etc):
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________

Project Chair/Sponsor (include name and address of individual who will chair project and payee for grant award):
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________

Amount Requested:_______________________________________________________________

Planned use of FFLA Grant (specifics, including date needed, etc):
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________

Overall Project Plan (include time frames, cost estimates, other expected partners and contributors, etc):
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________

FFLA Director Involvement or Notification:
________________________________________________________________________________

Include Photo for Files
________________________________________________________________________________

Grant criteria:
Grant request should be for a fire tower or lookout where funds would provide for stabilization, initial repairs, materials that would contribute to the restoration work, or for ongoing maintenance if otherwise uncared for. FFLA Grant funds may be used to leverage additional funding for larger projects. Advertising or other indirect support costs would not meet the intent of these criteria.

Grant request will be reviewed and forwarded to FFLA Executive Committee for approval. Appropriate FFLA Director will be involved in review, as well as in project tracking and reporting.

__________________________________Signature (electronic signature acceptable)

__________________________________ Date

Please make application to:
FFLA Chairman Keith Argow, FFLA Treasurer Gary Weber, or appropriate FFLA Director

form 1C  6/2006