CycleMAYnia Mini Grant Application 2016

1. Event cooordinator's info

Page1 / 5

This form is only necessary if you are applying for a Mini Grant for CycleMAYnia. If you are just registering an event, do so at CycleMAYnia.org by creating an event. Email Lori at llariva@sbcag.org if you would like assistance.

Question Title

1. Event name or idea

Question Title

2. Proposed date of your event.

Question Title

3. Your contact information

Name: *

Organization affiliation (if applicable):

Address: *

Address 2:

City/Town: *

State: *

ZIP: *

Email Address: *

Phone Number: *