Part I: Client Request for Information
1. Client Name
3. Phone Primary Cell
6. State 7. Zip (+4)
Part II: Optional Information
8a. Are you currently in business? Yes No
8b. Are you currently exporting? Yes No
9. Name of Business, Organization or Agency
10. Type of Business (select primary category)
11. Please share with us a brief summary of your request so that we will be better prepared to assist you.
12. Do you have a grant to which you plan to apply? Yes No
If you answered "Yes" to question 12 please continue filling out the request form below. Otherwise please submit your request now.
Request IMCP Designation Letter
*Requests are due three weeks prior to the proposal's submission date
13a. What grant are you applying for?
13b. When do you plan on submitting your grant proposal?
13c. Can you provide us with a web address for the grant?
14. What agency is administering the grant?
15. What organization/s do you represent?
16. How does your project support/implement strategies outlined in the South Kansas Manufacturing Community application and the Task Force Strategic Plan?
17. Please describe which organizations and counties the project involves and how they are involved.
18a. Does your project proposal intend to leverage funds or provide a dollar match?
18b. If yes, how much?
19. What impact/outcomes do you expect to achieve with this project?
20. Have you received a federal grant before? Yes No
21. Is there any other relevant information that you would like to share with us?