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State of Rhode Island
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Department of Environmental Management
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Organization Name
Point of Contact
First Name
Last Name
Organization Address
Organization Address
Address 2
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Organization Type
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Municipality
Non-profit organization
Corporation/LLC
Is your organization currently registered to conduct business in the state of Rhode Island?
- Select -
Yes
No
I understand that, if selected, my organization will be required to register to conduct business in Rhode Island prior to receiving a grant award.
Please list your organization’s mission:
Funding Request Type
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To teach swim lessons
To teach paddlecraft safety lessons
Funding Organization
Is your facility up to date in all CPR and First Aid Certifications?
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Yes
No
Is your facility in compliance with all RI Department of Health bathing facility rules and regulations?
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Yes
No
Is your facility up to date in all water safety instruction certifications?
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Yes
No
Do you own/rent/use a facility capable of holding paddle craft safety classes?
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Yes
No
Do your instructors possess an ACA (American Canoe Association) instructor certification?
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Yes
No
Do your lessons include an in-water component for students?
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Yes
No
If your facility is a waterfront facility, are all your lifeguards certified by the State of RI?
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Yes
No
Not Applicable
Do you utilize power boat for safety boats during any hands-on/underway portions of your class?
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Yes
No
If yes, do your operators possess a current boating safety card?
- Select -
Yes
No
If you answered no to any of the above questions, please explain:
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