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<br />e <br /> <br />e <br /> <br />APPLICATION FOR NAMING <br />A <br />CITY OF LA PORTE FACILITY <br /> <br />Please provide the infonnation requested and return this application to the City Secretary's Office. <br /> <br />Applicant Information <br />Name: <br />Address: <br />Phone: <br /> <br />Facility Information <br />Location: <br />Current Name: <br />Function or Facility: <br />Proposed Name: <br /> <br />Contributions <br />In the spaces provided below, briefly explain how the proposed individual, family, organization, <br />or entity has contributed to La Porte. You may use any combination of categories, as is <br />appropriate to the nomination, to describe the contributions made. For further assistance, please <br />refer to the Procedures and Guidelines for the Naming of Public Facilities. <br /> <br />Financial Contribution <br /> <br />Historical/Symbolic Contribution <br /> <br />Civic Contribution <br /> <br />4 <br />