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2. City of Brighton Grant Funding Reimbursement Request
4. Instructions

   If you have received a Brighton Creative Community Grant, please complete this form to request a grant reimbursement. Reimbursement requests can be made on a monthly basis. If you have any questions, please contact Public Art Coordinator Hannah Wold at hwold@brightonco.gov. 

6. Recipient Organization *
8. Contact Person*
10. Phone*
12. Project Name*
14. How much are you requesting to be reimbursed?*
16. Please describe how the grant funds were used:*
18. Receipts

    Please upload all of your receipts as one document. 

20. Is the project on track for completion by the end of the grant period?*

    1. Yes
    2. No
22. If you answered "no" above, please provide an explanation.
24. Please provide a brief update of progress, including any notable accomplishments or milestones as well as any unanticipated challenges or setbacks.*
26. Do you anticipate requesting additional reimbursements in later months?*

    1. Yes
    2. No
28. I certify that to the best of my knowledge and belief the information in this report is correct and that all expenses were made in accordance with the grant conditions and that payment is due and has not been previously requested. Please type your name below. *
30. Date*
    Date
Leave This Blank:


32. 1. Receive an email copy of this form.
33. Email address

    This field is not part of the form submission.

34. Submit

* indicates a required field