Project Information
What is the title of the project?
Please provide a short (2-4 sentences) non-technical description of the project.
Contact Information
Applicant:
a. First
b. Last
c. Title
d. Phone
e. E-mail
Organization:
a. Name
b. Street Address
c. City/Village/Township
d. State
e. Zip
Which of the following best describes the organization?
a. Private Sector For-Profit
b. Public Sector
c. Non-Profit
Property Information/Descriptions
Is the site currently owned by the applicant?
Yes
No
If no, please list current owner.
The project will principally be located in:
a. City/Village/Township:
b. State House of Representatives District #:
c. State Senate District #:
If applicable, please briefly explain how other jurisdictions may be impacted by the project.
Funding Information
What is the total project cost?
Please fill out the following information for any necessary project funding.
Source
(Please Indicated if
Public or Private)
Amount
Application Submitted?
(Y/N)
Please include any existing funding applications as exhibits.
Please briefly list the use of each funding source above.
Source 1:
Source 2:
Source 3:
Secured/Pending
Community Benefit
Please explain the benefit this project will bring to the community. If benefit can be numerically
quantified (job numbers, capital investment, etc.) please explain how numbers are calculated:
Additional Information
More detailed project information may be sent electronically to [email protected].
Additional information may include, but is not limited to:



Detailed description of project (maps/documents/project proposal/project charter/metrics,
benchmarks, etc.)
Project partners, sponsors, and supporters.
Negative effects of project not coming to fruition.
Please Check Here to Confirm Your Agreement to the Below Statement:
**Important Note: IF YOUR APPLICATION IS SELECTED, YOU WILL BE ASKED AND EXPECTED TO ATTEND
THE ANNUAL WASHINGTON D.C. FLY-IN AND/OR COLUMBUS CAPITOL DRIVE. THIS WILL ASSIST IN
CHAMBER ALLIANCE EFFORTS TO ADVOCATE EFFECTIVELY ON BEHALF OF YOUR PROJECT. ON A FEW
OCCASIONS, ESPECIALLY IN REGARDS TO FUNDING, YOUR PRESENCE MAY BE NECESSARY IN ORDER FOR
VARIOUS AGENCIES TO DISCUSS THE PROJECT IN DETAIL. FAILURE TO ATTEND CHAMBER ALLIANCE
ADVOCACY EVENTS MAY RESULT IN YOUR PROJECT BEING REMOVED FROM THE PRIORITY LIST.
Warren County Chamber Alliance
Project Evaluation System
Workforce Development/Education Sector (Addendum)
1. Does this training fall into a career path?
a. Yes ______ (3 pts.)
b. No ______ (1 pt.)
2. Will training be in partnership with a business or other educational facility?
a. Yes ______ (3 pts.)
b. No ______ (1 pt.)
3. Are there plans for sustaining training beyond the grant?
a. Yes ______ (3 pts.)
b. No ______ (1 pt.)
If yes, please explain:
4. What is the estimated average salary range for created jobs?
a. _____ $0-24,999 (1 pts.)
b. _____ $25,000-39,999 (2 pts.)
c. _____ $40,000-54,999 (3 pts.)
d. _____ $55,000 + (4 pts.)
5. How many people will be trained?
6. Will training support new industry technology, or support existing technology?
a. New _______ (4 pts.)
b. Existing _______ (2 pts.)
7. What are the deliverables of the training process? Please respond in 100 words or less. Up to 4 points possible.
8. How much risk is involved in this project? Please respond in 100 words or less. Up to 4 points possible.
9. What risk mitigation strategies will be implemented? Please respond in 100 words or less. Up to 4 points possible.
10. Which of the following best describes the created jobs:
a. ______ Full Time with Benefits (4 pts.)
b. ______Full Time (2 pts.)
c. Part-Time______ (1 pt.)
11. What is the primary driver of this project? Please respond in 100 words or less. Up to 4 points possible.
12. Is the source of your match funding confirmed?
a. Yes _____ (3 pts.)
b. No ______ (1 pt.)
13. Does this project require State of Ohio or industry recognized certification or criteria?
a. Yes _____ (3 pts.)
b. No _____ (1 pt.)
If yes, are the criteria met?
a. Yes _____
b. No _____
Clear Form
Submit