Letter of Support Request Form

Support Letter Details

Comments

This field is for validation purposes and should be left unchanged.

Support Letter Contact Person - Please include the name of the primary contact person for this request.(Required)

Support Letter Contact Person Phone Number - Please include the phone number of the primary contact person.(Required)

Support Letter Contact Person Email Address - Please include the email address of the primary contact person.(Required)

Support Letter Contact Person Role - Please choose which best describes the contact person.(Required)

Applicant

Engineer/Consultant

Other

Applicant Information

Applicant Name - Please include the name of the government entity or organization who is applying for the funding and will serve as the recipient for the funds.(Required)

Point of Contact- Please include the mailing address (city, state, and zip code) of the applicant.(Required)

Street Address Address Line 2 City State ZIP Code

Project Information

Name of Project - Please provide the name of the project that is the subject of the funding request.(Required)

Brief Description of the Project - Please describe the project, including a description of how the requested funding will be used.(Required)

Brief Impact of the Project - Please describe the benefits of the project to the community.(Required)

Total Project Cost - Please provide the total cost of the project local share.(Required)

Amount of Grant Funding Requested(Required)

Grant Program Name and Agency/Organization - Please name the agency/organization that administers the funding program.(Required)

Type of Funding(Required)

Grant

Loan

Tax Credit

Other

Application ID Number (if applicable) - If an application has already been submitted, please provide the application ID number (if available)

County - Please state the county in which the project is located.(Required)

Municipality - Please state the municipality (city/borough/township) in which the project is located.(Required)

Application - Please upload the project application if available.

Drop files here or

Accepted file types: doc, pdf, jpg, docx, Max. file size: 4 MB.

Support Letter Information

Addressee Name - Please state to whom the support letter should be addressed.(Required)

Addressee Title - Please state the functional title of the addressee.(Required)

Addressee Mailing Address - Please state the mailing address (city, state and zip code) of the addressee.(Required)

Street Address Address Line 2 City State ZIP Code

Support Letter Due Date - Please indicate the date by which the support letter is needed.(Required)