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1999 HISTORIC PRESERVATION FUND ( HPF ) APPLICATION FORM <br /> State Historic Preservation Office <br /> North Carolina Division of Archives and History <br /> 1 . PROJECT INFORMATION ( Please type or print with black ink) <br /> Title : <br /> Project Type : <br /> Archaeological Investigation <br /> Architectural Survey <br /> Survey Manuscript <br /> National Register ( NR) Nominations <br /> Architectural /Engineering Studies <br /> Restoration/ Rehabilitation ( NR Property ) ' <br /> Other ( Specify) <br /> lie APPLICANT INFORMATION <br /> Contact Person : Title : <br /> Address : <br /> Telephone : <br /> fax: e- mail : <br /> Applicant Organization or Agency : <br /> Applicant Organization or Agency federal ID # : <br /> Certified Local Government ( if applicable ) : <br /> Local Matching Funds : ( non -federal ) . Attach list if necessary . <br /> Donor : <br /> Source : <br /> Date Available : Kind ( cash/other) : Amount : <br /> 4 <br /> Local Project Coordinator: <br /> Address : <br /> Telephone : <br /> fax: e-mail : <br /> SIGNATURE AND TITLE : Officer of Applicant Organization DATE <br />