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Traffic Circle Grant application
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This form has been modified since it was saved. Please review all fields before submitting.
Grants are awarded to citizens who have signed an "Adopt a Traffic Circle" agreement and a volunteer release and waiver.
You may apply to "Adopt a Traffic Circle" at the following link: http://www.ci.missoula.mt.us/FormCenter/Neighborhoods-6/Traffic-Circle-Adoption-Agreement-162.
The maximum grant award is $150.00. Once your grant is approved, you can purchase your items. We will reimburse you for the approved amount on the invoice for your purchase that you provide us. Grants can be used for plants, mulch, soil amendments, etc. It cannot be used for items purchased in the past. It cannot be used for the purchase of any tools, with the exception of hoses. It also cannot be used to pay water bills. Expenditures must be pre-approved on grant application before claims are made.
First Name
*
Last Name
*
Address
*
City
*
Zip
*
Phone
*
Email address
*
What is the intersection that your traffic circle is located?
*
Have you signed an "Adopt a Traffic Circle" agreement, release and waiver?
*
Yes
No
Have you ever applied for, and received, a Traffic Circle grant before?
*
yes
no
If so, please give the date you received a previous grant.
If so, please give the date you received a previous grant.
How much are you asking for? (note, grant requests may not be over $150.00)
*
Please provide a list of items you would like to purchase for your traffic circle and the estimated cost and vendor(s) you expect to use:
*
City Use Only:
Date Received: ____________
City Use Only:
Approved: Yes: _____ No: _____
City Use Only:
Amount Approved: $ __________
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