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EQUITY & DIVERSITY COMMISSION <br />REQUEST FOR FINANCIAL ASSISTANCE* <br />*Re nests should be submitted no later than 60 days )rior to the date needed. <br />Applicant/Contact Information <br />Applicant Name: <br />(Applying Organization or Individual) Teens for Tukwila <br />Address: Tukwila Community Center, 12424 42nd Ave S <br />Today's Date: 11/30/2017 <br />Street Address <br />Tukwila <br />City <br />Contact Person: <br />Nate Robinson <br />WA <br />State <br />Suite # <br />98168 <br />ZIP Code <br />Title: Teen Recreation Program Specialist <br />Phone: (206) 768-2822 <br />Funding Request <br />Amount Requested: $5050 <br />Date Needed*: 9/21/2017 <br />Describe, in detail, how these funds will be utilized. Attach additional sheets as needed: <br />*No later than 60 days prior <br />These funds may be used to support travel, lodging, and or registration expenses for Teens for Tukwila <br />members to attend the National League of Cities Conference in Washington DC, March 11-14, 2018. This <br />conference includes a youth component, and promotes civic engagement among young people. Teens for <br />Tukwila members attended this conference in 2016. <br />How does your request for funding align with the Equity & Social Justice Commission Goals? (See back) <br />We are requesting funds from the Sister Cities and Civic Awareness Committee for this trip. As mentioned <br />above, this conference includes a youth component, and promotes civic engagement among young people. <br />For many Teens for Tukwila members this was the first time they flew on a plane, let alone had a chance to go <br />to the nation's capitol and address members of Congress. <br />Reinvestment Commitment <br />The Equity & Social Justice Commission is committed to the reinvestment of services. If you receive funding from the <br />Commission how do you prefer to reinvest your time and/or services to the Commission? (check all that apply) <br />❑ Volunteer to provide translation services. Please list languages: <br />❑ Attend monthly Commission meetings for (insert number) months. <br />❑ Perform (insert number) hours of community service by volunteering to (please describe): <br />Other, please describe: Teens for Tukwila members will fundraise to reimburse the City for a portion <br />• of the trip, TBD. <br />Return completed forms to: <br />City of Tukwila <br />Equity & Diversity Commission <br />6200 Southcenter Boulevard <br />Tukwila, Washington 98188 <br />4 <br />