Name of Organization Name of Authorized Official Title of Authorized Official Email Address Address City Zip Code Project must be in Missouri, Cass, Clay, Jackson, Platte or Ray counties. Telephone Number Federal Employer Identification Number Name of Project Amount Requested from District Project Description Project Partners List partners that you will be collaborating with on this project Project Budget Line item examples: *quantity, *cost per unit, *company/brand name. Be sure to include the TOTAL SUM of your request. Please enter itemized budget for your project. I Agree to submit reports quarterly on project progress, proper documentation for reimbursement, and measurables as determined and agreed to with the MARC SWMD staff: * I Agree Please type the security code: *