COTEAU DES PRAIRIES

**RESOURCE CONSERVATION & DEVELOPMENT COUNCIL**

**2740 22ND ST., STE. 2, SLAYTON, MN 56172**

**507-836-8933, Ext. 3**

**Fax -- 507-836-6697**

# *Please type*

# SPONSOR DATA

## Sponsor Name [\_\_]{.underline} Contact Person 

Address Telephone Fax

City State Zip

Legal Status of Organization (check all that apply)

\_\_\_\_\_\_\_ Profit Corporation

\_\_\_\_\_\_\_ Unit of Government

\_\_\_\_\_\_\_ Non-profit Corporation

\_\_\_\_\_\_\_ Unincorporated Group

\_\_\_\_\_\_\_ Other (please describe)

# PROJECT DATA

Project Name

Assistance Type Requested: (check one or more)

Technical Assistance

Information/Education Activities

Organizational Support

Planning Assistance

Grant Writing/Fund Seeking

Fiscal Agent/Financial Management Other:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

# PROBLEM STATEMENT

Describe the problem to be solved or the need that will be met by the
proposed project. Also list its effects on the local community or area.
If no direct effects, describe how solving the problem will improve the
quality and/or quantity of the resources affected or improved.

**[OBJECTIVE]{.underline}**

State specific, measurable objectives to show what will be accomplished
as a result of the proposed project.

**[ALTERNATIVES-METHODS]{.underline}**

List/explain all tasks and activities required to achieve project
success. (This section tells HOW you intend to reach the objectives
stated above-what will be done and what is the cost of each item that
will be done?)

**[BENEFITS]{.underline}**

State the benefits that the completed project will have on the economic,
social, & environmental conditions of the area.

**[IMPLEMENTATION STRATEGY]{.underline}**

List the actions that will be taken to implement and accomplish the
plan, year action will be completed, cost of action, and list the
individuals, agencies, organizations, that will assist with the
implementation/action.

**ACTIONS TO BE TAKEN YEAR COST WHO**

**[BUDGET]{.underline}**

List the local contributors and if it is a monetary, in-kind or other
contribution (please specify) and the dollar amount contributing.

**LOCAL CONTRIBUTORS MONETARY/IN-KIND/OTHER DOLLAR AMOUNT**

**[Total Local Contributions: \$]{.underline}**

**[Total Dollars Requesting from the RC&D Council: \$]{.underline}**

**[Total Cost of Project: \$]{.underline}**

**[SIGNATURE OF APPLICANT]{.underline}**

Signature of Applicant
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
Date\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪

**[LOCAL SPONSORS SCREENING AND APPROVAL]{.underline}**

**[County Commissioner's Board]{.underline}**

\_\_\_\_\_\_\_ Accepted

\_\_\_\_\_\_\_ Denied

Comments:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Chairperson-County Commissioner Board Meeting Date

**[SWCD Board]{.underline}**

\_\_\_\_\_\_\_ Accepted

\_\_\_\_\_\_\_ Denied

Comments:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Chairperson-SWCD Board Board Meeting Date

COTEAU DES PRAIRIES

**RESOURCE CONSERVATION & DEVELOPMENT COUNCIL**

Project Name:
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪

**Step 1: Accepted/Denied-add to list to Seek Funding/Other Assistance**

\_\_\_\_\_\_ Project accepted by the Council to be added to the list to
seek funding/other assistance (circle appropriate request). Other
Assistance (list)
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_ Project denied

\_\_\_\_\_\_ Need more information for Council action. Comments
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Signed\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
Date\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Council President

▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪

**Step 2: Approved for RC&D Funds or Seek Funding by Coordinator**

Reviewed by the Coteau Des Prairies RC&D Council on
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_(date).

\_\_\_\_\_\_ Approved for RC&D Funds

\_\_\_\_\_\_ Approved to seek funding by Coordinator

\_\_\_\_\_\_ Approved for other type of assistance
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_(list).

This measure addresses Objective #\_\_\_\_\_\_\_\_, Goal \_\_\_\_\_\_ of
the Coteau Des Prairies RC&D Council
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_(year) Work Plan.

Assigned Measure #:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ Reporting Code
(rcddatabase):\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Signed\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
Date\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Council President

▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪

**Step 3: Grant Approved/Denied**

The project was (\_\_\_\_\_\_ approved) (\_\_\_\_\_\_ denied) through
outside grant source (list)
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ and
was reviewed by the RC&D Council on
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ (date).
Comments

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Signed\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
Date\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Council President

▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪▪

**One Year Review**

One-Year Review-Letter stating intent from Contact Person received.
Reviewed by the Coteau Des Prairies RC&D Council on
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ (date).

\_\_\_\_ Continue to seek funding/other assistance. Current dollars
being requested \$\_\_\_\_\_\_\_\_\_\_

\_\_\_\_ Cancel Project

Signed\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
Date\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Council President