Note & Float Application

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Why are you interested in using the Note & Float™ program?
What limitations have you faced in implementing the program (why haven’t you used the program before)? Please be as specific as possible.
When do you plan to implement Note & Float™?
If you receive a donation of life jackets, what steps will you take to implement the program and ensure it is properly enforced? Please include a rough timeline of when you plan to move forward with each step.
Why do you wish to receive a life jacket donation from the Note and Float Life Jacket Fund?
Is there anything else we should know about your facility in considering your application?
What is the highest attendance at your facility on any given day?
Facility Name
Facility Address Facility Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Contact Name Contact Name First Last
Contact Email Address
Contact Phone Number Contact Phone Number - ### - ### ####
If awarded a donation of life jackets from Note and Float Life Jacket Fund:
- I will agree to use the Note & Float™ program, requiring that all non-swimmers wear properly fitting U.S. Coast Guard approved life jackets.
- It will be our responsibility to oversee the Note & Float™ program to ensure it is properly implemented and practiced.
- I will provide progress reports upon request, which includes an update of the program at the facility awarded.
If your facility is awarded this donation, Note and Float Life Jacket Fund (NFLJ Fund):
- Will provide life jackets for use by a facility to implement the Note & Float™ program.
- NFLJ Fund will reserve the right to use information, pictures, and videos about the Note & Float™ program at your facility for promotional and educational purposes.
- NFLJ Fund will be granted permission to visit the facility with advance notice.
- NFLJ Fund will provide unlimited email and phone support for the Note & Float™ program.
Applicant Name Applicant Name First Last
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Note & Float Application

Note & Float Application

If awarded a donation of life jackets from Note and Float Life Jacket Fund:

If your facility is awarded this donation, Note and Float Life Jacket Fund (NFLJ Fund):