SCAG

I. GENERAL INFORMATION
A. APPLICATION INFORMATION
If an agency/organization is submitting more than one application, only one application needs to include all the information requested in Questions 1-13.

Additional applications must fill in Questions 1 and 7, and can leave the remaining Questions 2-13 blank if the information is the same across all applications.
1. Agency/Organization*
2. City
3. County
4. Project Manager Name
5. Project Manager Title
6. Project Manager Department
7. Project Manager Email*
8. Project Manager Phone
9. Additional Contact Name
10. Additional Contact Title
11. Additional Contact Department
12. Additional Contact Email
13. Additional Contact Phone Number
B. PROJECT INFORMATION
14. Project Name*
15. Please provide a short summary of your project that includes the major deliverables*
16. Project Duration (Years, Months)*
17. Requested Amount*
18. Local Match (Please type N/A if this does not apply.) Please note: A local match is optional and not scored as part of the application. A local match will not increase the competitiveness of the application.*
19. Is your agency submitting multiple applications?*

a. Yesb. No
20. How many applications is your agency submitting?
21. What is the priority of this application (e.g. 1, 2, or 3)
22. Project Type*

Community/Areawide PlanQuick-Build