Application for Assistance
Applicant’s Name: _________________________________
(Please Print)
Street Address: ________________________________________________
________________________________________________
Phone: _____________________________________AM / PM
Cell: _____________________________________
Description of Need:
________________________________________________________________ ________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
Name of Person Completing Form: __________________________________
(If Other Than Applicant Above)
Phone: ________________________________________________
IMPORTANT: PLEASE READ
While Together for Lincoln will make every effort to provide assistance for all those who request and need it, we can not guarantee that all requests will be able to be filled.
You will be contacted when the decision has been made regarding your project.
Return this form to: _______________________________________________
_______________________________________________
Application Deadlines: 1. For construction requests, return application
before: July 1, 2008.
2. For all other project requests, return application before: August 15, 2008.