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Intent to Apply for I-JOBS

The following information is provided concerning a potential application for funding from the I-Jobs Local Infrastructure Competitive Grant Program.

Project Information:
Project Name: *
Applicant(s): *	(Eligible applicants include a city, county, public organization -- defined as a nonprofit organization that sponsors or supports the public needs of one or more local Iowa communities.)
Applicant Organization: *
Contact Information:
First Name: *
Last Name: *
Title: *
Address 1: *
Address 2:
City: *
County: *
State/Zip Code: *	/
Phone: *
Fax: *
E-mail Address: *
Type of Project: *
Brief Description of Project, Including Total Projected Cost:

Expected Amount of Funding To be Requested: *
Expected Application Date: *	The I-JOBS Notice of Intent to Apply must be submitted at least 20 days prior to submitting the application for the Local Infrastructure Competitive Grant Program. That application will be available on July 1, 2009.
Other Sources of Funds and Amounts:

* We understand submission of this Notice of Intent to Apply is not a binding commitment, but a good faith effort to inform the I-Jobs Board and staff of our intent to apply. We agree to provide updated information as changes to these plans become known. I understand that all information submitted relating to this Notice of Intent to Apply is a public record.
Date Form Signed: *
Initials: *