EEA Application - project 1

Applicant Information

Applicant Name:

Applicant Email:

Applicant Phone:

Applicant Supervisor:

Applicant Director:

Date Submitted:

Status: In Review

Total Score:

A. Applicant is OSD Employee: Yes

B. Narrative does not exceed 2-3 pages: Yes

C. Application includes budget: Yes

D. Request discussed with OSD departments:

E. Application has all required signatures: Yes

Score:

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PO Box 15053
Salem, Oregon 97309

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