Request For Assistance Form
Pine Country Resource Conservation and Development Council, Inc.
1905 Martin Luther King Drive, Suite C, Soperton, Georgia 30457
Phone: (912) 529-6652 (912) 529-6652 FAX (912) 529-6000
Project Proposal
Date: ____________________ Project Name: _________________________________________________
County: ________________________ Location: _______________________________________________
Email: __________________________________________________________________________________
Sponsoring organization (city or county government, SWCD, community organization):_____________________
Name of Primary Contact: _______________________________________ Phone: __________________
Description of Project: _______________________________________________________________________
_________________________________________________________________________________________
Expected Benefits: _________________________________________________________________________
Assistance Needed (technical, landscape architect, etc.): _____________________________________________
Financial Assistance Needed: _________________________________________________________________
Estimated Total Cost: ________________________
This proposal must be approved and signed by a council member from the originating county and forwarded to the council office.
RC&D Council Member: ___________________________________ Date: _______________________
Serving the Counties of Bleckley, Dodge, Emanuel, Johnson, Laurens, Montgomery, Pulaski, Telfair, Toombs, Treutlen, Washington, Wheeler, and Wilcox.