ARPA Project Suggestion Form for Community Members

A.) Name

First

Last

B.) Contact Email

C.) Primary Phone

D.) Address

City

State/Province

Zip/Postal

E.) Age

F.) Gender

G.) Race/Ethnicity:

Are you Hispanic/Latino?

Yes

No

H.) Disability (optional)

I.) Housing Tenure

Project Title

Project Category

Please enter project description (include details, location, logistics, etc..).

Please provide any project timeline and cost details (project milestones, scope of work, etc..).

Please upload any additional files.

Maximum upload size: 516MB

Signature of Project Requestor

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