Rural Community Intake — Southwest Arkansas Planning and Development District

RCGP Intake Form

Arkansas Rural Community Grant Program

Project Intake Form — Southwest Arkansas Planning & Development District, Inc.

Project Info

Need & Impact

Financials

Fire Dept

Review

Project Information

Basic details about your community and the project you are applying for.

Applicant Name (City or County)*

County*

Primary Contact Person*

Contact Phone Number*

Contact Email Address* A copy of your submission will be sent to this address for your records.

What is the project you are applying for?* Describe what will be purchased, built, or improved. Be specific.

Who was involved in the development of this proposal? List individuals, organizations, fire department leadership, community groups, etc.

Need & Community Impact

Help us understand why this project matters and who it will serve.

Why is this project needed?* Describe the problem, any urgent conditions, safety concerns, or deteriorating equipment that makes this project necessary.

Who will be the beneficiaries of this project and how will they benefit?*

Name the closest comparable facility and the distance from this project. For example, the nearest fire station with similar equipment, or nearest park of the same type.

List other equipment, facilities, and resources currently being used that are relevant to your application. Please also list the condition they are in. This helps reviewers understand the current situation and the urgency of the need.

Funding & Future Operations

Tell us how the project will be sustained and whether other funding has been explored.

What funding and other resources will be used to maintain and operate the project in the future?* Include Act 833 funds, membership dues, county appropriations, or other ongoing funding sources.

Have you asked any other funding sources to help pay for this project?*

No (that is ok) Yes

Fire Department Application

The following section is required only if this is a fire department application.

Is this a fire department application?*

No Yes

Review Your Responses

Please review all information below before submitting. Your responses will be emailed to Southwest Arkansas PDD staff.

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Intake Form Submitted

Thank you. Your responses have been received by Southwest Arkansas PDD staff. We will review your information and be in touch to confirm your application details and next steps for the grant packet.

A copy of your submission has been sent to the email address you provided. Questions? Contact Shelley Morehead at (870) 235-7504 or Jay Click at (870) 235-7501.

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While You Wait — Start Gathering These Items

Your PDD staff will be in touch soon. In the meantime, start pulling these documents together so your application can move quickly.

Required for All Applications

Signed Certification Letter (Attachment A) — signed and dated by the Mayor or County Judge
Dated and numbered Resolution — passed by City Council or Quorum Court, signed by Mayor/Judge and City/County Clerk
Cost estimate itemizing all project expenses — written professional quotes required for each line item
Proof of matching funds — bank statement or letter confirming the full local match is available
Letter of support from your State Senator
Letter of support from your State Representative(s)

Southwest Arkansas PDD will prepare the required 8.5" x 11" service area map, Certification Letter, and Resolution on your behalf.

Questions about what to send? Contact Shelley Morehead at (870) 235-7504 or [email protected], or Jay Click at (870) 235-7501 or [email protected]

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