Verona Area Chamber of Commerce

Verona Area Chamber of Commerce Tourism Grant Request Form

Date: ______

Organization Name: ______

Contact Person: ______Phone #: ______

Address: ______

Email Address: ______Fax #: ______

Project / Event Information

Name of Project/Event: ______

Project/Event Date(s): ______

Event Location/Site(s): ______

Person(s) responsible for coordination of Event/Project: ______

Please describe the event/project as completely as possible (attach additional sheets if necessary): ______

How will the event/project promote visitors to come to Verona? ______

What market are you targeting and why? VACC Tourism Grant Request Form Revision Date: 2/11/09 Page 1 of 3 If you intend to use the grant toward an event, please provide your best estimated answer to the following questions. Applicants will not be held liable if estimates are inaccurate, but failure to estimate could result in your application being denied.

Please estimate the number of people who will be directly participating in this event: ______

Please estimate the number of non-participants who will come to Verona for this event (parents of participants, spectators, etc.): ______

How many of these people live outside Verona? ______

How many of these people live outside Dane County? ______

Is this an annual event? Y N Do you anticipate it becoming and annual event? Y N

Do you anticipate people attending this event will require hotel accommodations? Y N

Financial Information

How much money are you requesting from the Verona Area Chamber of Commerce for this event? $______

If grant is provided in full, the grant would be ______percent of the total project/ event budget.

Please describe in detail how grant money from the Verona Area Chamber of Commerce would be used to fund your event/project and how your request fulfills Section 66.0615(1)(fm) of the WI State Statues ( ... must be spent on marketing projects to attract tourists… reasonably likely to generate paid overnight stays…). If applicable, describe how the funds from the Verona Area Chamber of Commerce would enhance your event in comparison with previous years. Also include any other information you feel would be relevant in evaluating your application. You may complete this answer on a separate piece of paper, if necessary.

A Summary Report must be submitted to the Verona Area Chamber of Commerce within thirty (30) days of your event. Summary information must include (but is not limited to)

VACC Tourism Grant Request Form Revision Date: 2/11/09 Page 2 of 3 the following: number of attendees, number of overnight hotel stays, and an explanation of how room tax funding was spent (include receipts, where applicable).

In applying for a Verona Area Chamber of Commerce Tourism Grant, I understand that grant money is intended to promote tourism, economic development, and/or general community well- being within Verona. I further understand this application for a grant does not guarantee acceptance. I agree to provide additional information to support this application if requested, and will appear in person before the Chamber’s Room Tax Subcommittee if required. I agree to comply with any stipulations placed on my grant by the Verona Area Chamber of Commerce.

Name (print): ______Organization: ______

Signature: ______Date: ______

Office Use Only

Date Received: ______

Granted: $______Date: ______

Financial Info Received: ______Date: ______

Summary Report Received: _____ Date: ______

Notes: ______

Denied: ______Date: ______

Reason for Denial: ______

______

VACC Tourism Grant Request Form Revision Date: 2/11/09 Page 3 of 3