Please Complete ALL Pages and Email To

Marine ConservationGrant Application

The 2014 grants are focused on projects that enhance fish populations including: (1) engaging anglers in data collection, (2) enhancing marine habitats, and (3) educating anglers about barotrauma. Preference is given to organizations that work with local West Marine stores.

Please complete ALL pages and Email to:

West Marine will accept Marine Conservation Grant Applications between March 15and May 1, 2014

Organization Information

Organization Name:
Contact Phone Number:
Contact Name and Email Address:
Shipping Address:
City, State and Zip:
Is your organization a Non-Profit 501c(3)? Yes No
If “Yes”, please provide your not-for-profit Tax ID #:
Number of Paid Staff and Volunteers in your organization:
Organization’s annual budget:
What is the location of your nearest West Marine store?

Project Manager Information

Name and Title of Person Overseeing Project:
Address for all mailed correspondence:
Telephone and Email Address for Project Manager:

About Your Organization

Please describe your organization (150 words or less):
Tell us about the general nature, extent and location of your group’s activities – please be sure to explain your current conservation and/or environmental activities(please be specific):

About Your Project

Tell us about your proposed project and your primary use for the Marine Conservation Grant – what do you hope to accomplish? (150 words or less):
Describe the waterbody, fish population, and environmental concern that your project is intended to reach:

How do you intend to support and maintain the project if it is selected to be a grant recipient?:

One of our goals is to get our local stores involved with the grant projects, how would you envision involving the West Marine local store as a champion of the project?:

Total Grant amount requested (up to $5,000 cash or in-kind value). Below, or on an attached page, please tell us in detail what funds will be needed to complete your project and how funds will be used. List any in-kind products requested.

Are there any other sources of funding to be applied to this project? If yes, please describe.

Has your organization received any other grants within the past five years? If yes, please provide a detailed list.

I agree to the following:

1.To name West Marine as a contributor to the program in any published materials (i.e. newsletters, annual reports, website, etc.): Yes No

2.To forward copies of the above and photos to the address below: Yes No

3.To release and provide photographs of activities for use by West Marine: Yes No

Name/Title:

Date:

West Marine

Grants and Sponsorships

500 Westridge Drive

Watsonville, CA 95076

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