PROJECT LEAD Name Title Name Agency/Organization Address City State Zip CONTACT INFORMATION Phone E-mail Habitat Enhancement Equipment Education Research PROJECT TYPE (Check all that apply) Hunter Safety Land Acquisition Management Location (County, Legals, closest town) Land Status USFS Private State Civic Other Please Explain (Check all that apply) hunting Access (Benefit to Hunting) Yes No NWTF Membership status NWTF Member project costs $ Total Cost of Project (An itemized budget table outlining $ Amount Requested from NWTF expenses, cash, in-kind, etc. should be % Requested from NWTF included in the project proposal) Cooperators 1. Amount $ 2. Amount $ PARTNERS & MATCHiNG FUNDS 3. Amount $ 4. Amount $ (Minimum match rate of 3:1 is suggested) 5. Amount $ 6. Others Direct Acres = Project Scale Statewide Regional Local INDIRECT = PARTY RESPONSIBLE FOR NAME: ESTMATED ANNUAL $ FUTURE MAINTENANCE New Project PROJECT HISTORY Ongoing project with previous Super Fund commitments Ongoing Project w/out previous Fund commitments PARTNER HISTORY New partners and funding sources have been secured (since last application) (IF previously funded by New partners and funding sources have not been secured NWTF)
PROJECT LEAD Name Title CONTACT INFORMATION Name Agency/Organization Address City State Zip Phone E-mail PROJECT TYPE (Check all that apply) Habitat Enhancement Equipment Education Research Hunter Safety Land Acquisition Management Location (County, Legals, closest town) Land Status (Check all that apply) USFS Private State Civic Other Please Explain hunting Access (Benefit to Hunting) NWTF Membership status NWTF Member Yes No project costs (An itemized budget table outlining expenses, cash, in-kind, etc. should be included in the project proposal) $ Total Cost of Project $ Amount Requested from NWTF % Requested from NWTF Cooperators PARTNERS & MATCHiNG FUNDS (Minimum match rate of 3:1 is suggested) 1. Amount $ 2. Amount $ 3. Amount $ 4. Amount $ 5. Amount $ 6. Others Project Scale Direct Acres = INDIRECT = Statewide Regional Local PARTY RESPONSIBLE FOR FUTURE MAINTENANCE NAME: ESTMATED ANNUAL $ PROJECT HISTORY New Project Ongoing project with previous Super Fund commitments Ongoing Project w/out previous Fund commitments PARTNER HISTORY (IF previously funded by NWTF) New partners and funding sources have been secured (since last application) New partners and funding sources have not been secured
OHSFProposal-Form03112014.docx