Fillable Printable Project Budget Form - Pride of New York
Fillable Printable Project Budget Form - Pride of New York
Project Budget Form - Pride of New York
Page 1
Project Budget Form
Pride of New York “BuyLocal” Specialty Crop
Cooperative Advertising Program
________________________________________________________________________________________________________________________________________
Member Name: ______________ _________________________________ _______ Telephone: ____________ _________ ____________________________
Business Name: ____ __________ __________ _________________ _________ ___ E-Mail: _____________________________________________________
Address: ____________________________________ ___________________ ____ Federal ID #/ Social Security #: _________________________________
(Needed for reimbursement purposes.)
City: _____ _______________________________ __________________________
Fax: __________________ _________________ _________________ ___
State: __________________________ ______________ Zip: ________________
________________________________________________________________________________________________________________________________
Custom-Built Television
Buy
Station Selected
Proposed Station
Total NET Cost
(Commission charg es are
not allowed.)
Proposed Amount of
Cooperative F unding
Match
Total Project Cost
$ $
$ $
$ $
Custom-Built Radio Bu y
Station Selected
Proposed Station
Total NET Cost
(Commission charg es are
not allowed.)
Proposed Amount of
Cooperative F unding
Match
Total Project Cost
$ $
$ $
$ $
$ $
____________________________________________________________
Program Use Only
Approved by: ___________ _________________ __ Date: ____________
Notes: _________ _________________ ____________________________
_____________________________________________________________
Page 2
Print Buy
(Daily, Weekly, Monthly)
Publication Selected
Proposed Publication
Total NET Cost
(Commission charg es
are not allowed.)
Proposed Amount of
Cooperative F unding
Match
Total Project Cost
$ $
$ $
$ $
$ $
Point of Purchase and
Promotional Items
Proposed T otal NET Cost
(Commission charg es
are not allowed.)
Proposed Amount of
Cooperative F unding
Match
Total Project Cost
$ $
$ $
$ $
$ $
I certify that the amount of reimbursement being requested will not exceed the e stimate s provided.
___________ ____________ _______________________________________________ ____________
Print Name Signature Date
