Cooperating Agencies:
University of Missouri Outreach and Extension, USDA Natural Resources Conservation
Service,
Missouri Department of Natural Resources, Missouri Department of Conservation
Communities needing assistance with watershed management issues need to print this
form, then complete the form and submit it to their local University Of Missouri Outreach and Extension
office.
Name of community/group requesting assistance _____________________________________
Contact person: Name: __________________________________
Address _________________________________City _____________________ Zip ________
Phone: Day ________________ Evening _________________ E-Mail __________________
Organizational Status:
Not for Profit ___
A political subdivision: City___ County ___ Other________________________________
Educational Institution: K-8 ___ 9-12 ___ College or University ___
Other than above ________________________________________________________________
Briefly describe the primary objective of the proposed project. ______________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
What type of assistance is needed? (check all that apply)
___ Community organizing/coalition building
___ Technical assistance
___ Problem identification/evaluation
___ Project evaluation (review of project, proposal organization, proposal preparation)
___ Identifying technical/ funding sources
___ Other _____________________________________________________________________
Describe the geographic area for which assistance is being requested (neighborhood, city, county, multi-jurisdictional).
_____________________________________________________________________________
_____________________________________________________________________________
What impact do you expect to have on your watershed as the result of this effort?
_____________________________________________________________________________
Use space below if more is needed