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Réunica - Dossier de candidature - Appel à projet "Des initiatives ...

Réunica - Dossier de candidature - Appel à projet "Des initiatives ...

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IDENTIFICATION<br />

DU PORTEUR DE PROJET<br />

IDENTITE DE L’ASSOCIATION<br />

Nom <strong>de</strong> l’association : ______________________________________________________________________________________________<br />

Adresse complète du siège social : ____________________________________________________________________________<br />

Tél : ________________________________________________________________________________________________________________________<br />

Courriel : _________________________________________________________________________________________________________________<br />

Site internet : __________________________________________________________________________________________________________<br />

Adresse <strong>de</strong> correspondance si différente : __________________________________________________________________<br />

RESPONSABLE DE L’ASSOCIATION ET DU PROJET PRESENTE<br />

Nom du représentant légal <strong>de</strong> l’association : _____________________________________________________________<br />

Fonction : _______________________________________________________________________________________________________________<br />

Tél : ________________________________________________________________________________________________________________________<br />

Courriel : _________________________________________________________________________________________________________________<br />

Nom <strong>de</strong> la personne en charge du dossier présenté : __________________________________________________<br />

Fonction : ________________________________________________________________________________________________________________<br />

Tél : ________________________________________________________________________________________________________________________<br />

Courriel : _________________________________________________________________________________________________________________<br />

PRESENTATION DE L’ASSOCIATION<br />

Précisez l’objet <strong>de</strong> l’association :<br />

______________________________________________________________________________________________________________________________<br />

______________________________________________________________________________________________________________________________<br />

______________________________________________________________________________________________________________________________<br />

Décrivez en quelques mots votre <strong>projet</strong> associatif :<br />

______________________________________________________________________________________________________________________________<br />

______________________________________________________________________________________________________________________________<br />

______________________________________________________________________________________________________________________________<br />

______________________________________________________________________________________________________________________________<br />

______________________________________________________________________________________________________________________________<br />

______________________________________________________________________________________________________________________________<br />

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