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Community Development - Information Request Form

2. Community Development - Information Request Form
   Please fill out the questions below to help us send you the correct information.

   Please fill out the questions below to help us send you the correct information.

4. First Name

5. Last Name

7. Organization

9. Address

11. Address Line 2

13. City

14. State

15. Zip Code

16. Country

18. Email Address*

20. Do you serve Jefferson County residents?*

    1. Yes

    1. No

22. Are you a non-profit 501(c) 3?*

    1. Yes

    1. No

26. Request Information
    Please check all information that you are interested in receiving.

    Please check all information that you are interested in receiving.

28. Community Development Block Grant

    1. Annual Plan
    2. Consolidated Annual Performance Evaluation Report
    3. Consolidated Plan
    4. General Information
    5. Guidelines

30. Home Investment Partnerships Grant

    1. General Information
    2. Guidelines
    3. Relocation Act Information

32. Community Services Block Grant

    1. General Information
    2. Guidelines
    3. ROMA Information

34. Comments / Other Requests

Leave This Blank:


36. 1. Receive an email copy of this form.
37. Email address

    This field is not part of the form submission.

38. Submit

* indicates a required field