HomeMy WebLinkAboutgrant signers -tbayGrant Documents Authorized Signers
Please clearly print or type all sections of this form.
Community/Grantee Name: Southeast Island School District. Thome Bay Wood Boiler
Project
Regular Election is held: School Board Elections —
Date: September 5, 2010
October 2010. as seats become vacant — 3 year
seat rotation, Superintendent is hired by the school
board.
Authorized Grant Sianer(s):
Printed Name
Title
Term
Signature
Lauren Burch
Superintendent
n/a
rj
I authorize the above person(s) to sign Grant Documents:
(Highest ranking organization/community/municipal official)
Printed Name
I Title
Term
Signature
Lauren Burch
Superintendent
nla
Grantee Contact Information:
Mailing Address:
PO Box 19569 Thorne Bay, AK 99919
Phone Number:
(907) 828-8254
Fax Number:
(907) 828-8257
E-mail Address:
Iburch gnsisd.org or Cpage(o),sisd.orq
Federal Tax ID #:
92-0057120
Please submit an updated form whenever there is a change to the above information.
Please return the original completed form to: A t /t [^ t / /f,
Alaska Energy Authority - /L]lll.. Lr]`.\JtKVL]\
813 W. Northern Lights Blvd. ENERGY AUTHORITY
Anchorage, AK 99503 dill
Attn: Butch White, Grants Administrator
Macintosh HD:Users:chrispage:Dowments:Gmnts;Alaska Energy
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