Arc Form 3 - Non-Construction Project Application

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A
R
C
ppalachian
egional
ommission
Program Operations Division
1666 Connecticut Ave, NW Phone 202-884-7750
Washington, DC 20009
Fax 202-884-7682
ARC FORM 3
: Application for Non-Construction Projects
NON-CONSTRUCTION PROJECT APPLICATION
ARC Project Control No.: _______________________________
(assigned by ARC Washington Office)
Send three copies of project application to State ARC Office.
1. IDENTIFICATION
Project Title
Location
State
2. ARC Goal Area
(check appropriate box)
A.
Economy
B.
Education/Health
C.
Infrastructure
D.
Highway
E.
Other
Specify:
3. Type of Project
(check appropriate box)
A.
Operations Only
B.
Operations (including equipment)
C.
Equipment Only
D.
Training and/or Technical Assistance
4. Budget Period: From_____________________
To____________________
5. Cost Request for this Budget Period:
Funding
Operations/TA
Equipment
Total
Dollars
%
Dollars
%
Dollars
%
ARC Funds
Other Federal Funds
State Funds
Other Funds
(non-federal)
Total Cost
100 %
100 %
100 %
Specify source of all other Federal funds and approval date(s):
ARC Form 3: Application for Non-Construction Project (page 2)
ARC Form 3, Page 1
Revised 2005

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