2013 CEDS Projects

1. Select the county(s) that this project impacts. *This question is required.

2. Submitted By (Name): *This question is required.

3. Mailing Address:

4. Phone Number: *This question is required. This question requires a valid number format.

5. Email: This question requires a valid email address.

6. Organization You Represent:

7. Project Name: *This question is required.

8. Description: *This question is required.

9. Location (City, Village, or Township): *This question is required.

10. Estimated Cost:

11. Estimated Number of Jobs Created: *This question is required. This question requires a valid number format.

12. Funding Sources You Anticpate Using:

13. Projected Implementation Date:

14. Status of Project (select one):

15. Engineering Firm:

16. Person to Contact:

17. Phone Number: This question requires a valid number format.

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