Makeover Middlesex Application

Current Applicant Information:
Project Information:
Budget:
Complete

Name of Applicant(s):

Position/Role:

Name of Lead Business/Organization:

Street Address:

Postal Code:

City/Town:

Business Phone Number:

Cell Phone Number:

Email Address:

Website:

Provide an itemized cash budget for your project using the following table and send quotes for the costs your are including with your application to info@visitmiddlesex.ca.

Cash Budget
	Provide an itemized cash budget for your project using the following table and send quotes for the costs your are including with your application to info@visitmiddlesex.ca.	Item weight

more items

Please list type of expense, cost, source of revenue and purpose of expense.

Total budget:

Requested funding amount:

Describe the target market for this piece of public art. What kind of visitors do you think this would attract and for what reason? What purpose would it serve the local community? Do you believe this would be a long-standing addition to the designated area?

If you indicated above that you do not own the property in which you plan to locate your public art, please have the property owner acknowledge consent by emailing info@visitmiddlesex.ca.