Letter of Support Request Form

Name

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

Applicant

Applicant Name – Please provide the name of the ELIGIBLE applicant who is applying for funding and will serve as the recipient of the funds.(Required)

Is the eligible applicant applying on behalf of another organization?(Required)

Yes
No

Please provide the name of the organization who the eligible applicant is applying on their behalf:

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

Support Letter Contact Person Role(Required)

Applicant
Engineer/Consultant

Address – Please include the mailing address (city, state, and zip code) of the applicant.(Required)

Street Address Address Line 2 City State ZIP Code

Contact Person Phone Number(Required)

Contact Person Email Address(Required)

Grant/Loan

Funding Department, Agency, Bureau, etc. (e.g. DCED, PDOT, etc.)(Required)

Funding Program (e.g. Local Share Account, Multimodal Transportation Fund, etc.(Required)

Type of Funding(Required)

Grant
Loan
Tax Credit

Project Name(Required)

Application ID Number, if application submitted

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

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

Municipality(Required)

County(Required)

Requested Amount(Required)

Total Project Cost(Required)

Brief Description of the Project(Required)

Brief Impact of the Project(Required)

Will the ELIGIBLE applicant be requesting another support letter under the same funding department and program but for a different project?

Yes
No

Second Letter of Support

Support Letter Handling

To whom should the letter be addressed/directed?(Required)

First Last

Please provide the title of the above addressee(Required)

Please provide the organization/department/agency of the above addressee(Required)

Please provide the mailing address of the above addressee(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Support Letter Extra Copies

Please provide the names and Mailing addresses (if hardcopy) or email addresses of where support letter extra copies should be sent.

Support Letter Due Date(Required)

Please allow at least two fully operational business days.

If submitting more than one project, please designate which project name is the highest priority here: