Grant Program Application Form

Friday, May 18, 2012

IPRF Grant Application

Grant Application Information

Organization Name:

IPRF Customer No.

Address:

City:

Zip Code:

Phone Number:

Fax Number:

Email Address:

Grant Applicant’s Name and Relationship to Organization:

Grant Request Information

Purpose of Grant:

Total Project Cost:

Requested Amount:

Other Comments:

Illinois Public Risk Fund Safety and Educational Grant Request Criteria

Applicants submitting Grant requests shall assure that the request applies to one or more of the following established purpose statements enumerated below.

Please check the purpose statement(s) you are intending to use the Grant for. Attach this form to your Grant Application.

To conduct or cause to be conducted research or training for governmental employee safety education

To provide educational grants for educational institutions, municipal and state governmental units for training, and safety and educational programs remove edit sort

For the purchase of safety equipment

Name:

Title:

Date:

Contact IPRF

Exclusive Marketing Agent:
Boyle, Flagg & Seaman, Inc.
7941 W. 171st Street
Tinley Park, IL 60477
ph (708) 429-6300
ph (800) 289-IPRF
fax (708) 429-6488
Email Tom English

IPRF Grant Program

Click on a link below to view and download the document you need.

Contact Information

Exclusive Marketing Agent:
Boyle, Flagg & Seaman, Inc. • ph (708) 429-6300
For Loss Control:
Donna Ryan • ph (630) 649-6082
For Claims:
Paul Boecker, III • ph (630) 649-6053

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