This form has been designed to provide summary information for your request for technical assistance from NMCOG. Separate forms should be submitted for each requested project. After completing this form, click/tap submit. Please use as many lines as you need for each brief answer.

Question Title

* 1. Municipality:
In the event that this is a multi-municipal request, indicate the lead municipality for the submittal, all other participating municipalities, and whether commitments have been secured from participating municipalities.

Question Title

* 2. Contact Person:
Identify a lead contact for the request

Question Title

* 3. Description of Request:
Provide a description of the request, including work products or processes, the specific final deliverable desired, and its intended benefit for your municipality or municipalities.

Question Title

* 4. Relationship of Request to Local and Regional Goals:
Describe how the idea advances relevant previous and current local and regional planning efforts, e.g., plans, reports or studies.

Question Title

* 5. Matching Funds:
If your municipality can commit to matching funds, either from CPA, grants, municipal budget, etc., please indicate the amount or percentage that can be provided.

Question Title

* 6. Project Timeline (optional):
If the project has any specific deadlines, e.g., must be completed in time for close of a Town Meeting warrant, please include that information.

Question Title

* 7. Project Hours (optional):
If you have an estimate of hours of assistance you believe is necessary to complete the deliverable, please indicate your estimate. NMCOG will work with the project contact to develop a scope of work for selected projects and may adjust the number of hours/budget awarded based on that scope.

T