Letter of Support Request Form

Senator Gebhard's Letter of Support Request

Grant Applicant(Required)

Contact Person(Required)

Address(Required)

Street Address Address Line 2 City State ZIP Code

Phone Number(Required)

Email Address(Required)

Project Name(Required)

Application ID Number, if application submitted

Application has been submitted, please provide a copy of your application

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

Accepted files are doc, docx, pdf or jpg.

Municipality(Required)

County(Required)

Requested Amount(Required)

Total Project Cost(Required)

Funding Program(Required)

Funding Department, Agency, Bureau, etc.(Required)

Brief Description of the Project(Required)

Brief Impact of the Project(Required)

Support Letter(Required)

Yes

To whom would you like electronic/mailed letters directed?

Support Letter Name

Support Letter Title

Support Letter Email

Support Letter Address

Street Address Address Line 2 City State ZIP Code

Support Letter Date

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