Form Center

Traffic Circle Grant application

2. Grants are awarded to citizens who have signed an "Adopt a Traffic Circle" agreement and a volunteer release and waiver.
   <br> 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. <br> <br> 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.

   
   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.

4. First Name*

5. Last Name*

7. Address*

9. City*

10. Zip*

12. Phone*

13. Email address*

15. What is the intersection that your traffic circle is located?*

17. Have you signed an "Adopt a Traffic Circle" agreement, release and waiver?*

    1. Yes
    2. No

18. Have you ever applied for, and received, a Traffic Circle grant before?*

    1. yes
    2. no

20. If so, please give the date you received a previous grant.
    If so, please give the date you received a previous grant.

21. How much are you asking for? (note, grant requests may not be over $150.00)*

23. 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:*

25. City Use Only:
    Date Received: ____________

    Date Received: ____________

26. City Use Only:
    Approved: Yes: _____ No: _____

    Approved: Yes: _____ No: _____

27. City Use Only:
    Amount Approved: $ __________

    Amount Approved: $ __________

Leave This Blank:


29. 1. Receive an email copy of this form.
30. Email address

    This field is not part of the form submission.

31. Submit

* indicates a required field