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0Y1III K II"J, 't e =Y Y <br />011110110 1 ba,�G 1"'4"S 1w T 0 <br />IIIIII III I .IIIIIIII VIII II IIII, I IIIIIIIIIII I I III 1111111 IIIIII, IIICI III 1111111 IIII IIIIIIIIIII III IIIIIIIIIIIIII II IIIIIIIIIII IIIIII VIII, IIIICIII III IIIIIIIII IIIIIIII VIII, VIII, IIICI IIIIII IIIIIIII III III IIII VIII VIII, II IIII IIIIIIIII I IIII, IIII, I I III II (IIIIIIIII II IIIICI II <br />Proposed Project Location <br />Address /description of location: <br />Name of business or organization: <br />City: <br />State: <br />Zip Code: <br />Contact person: <br />Title: <br />Address: <br />Employer: <br />City: <br />State: <br />Zip Code: <br />Email: <br />Phone: <br />Fax: <br />Project lead: <br />(if different from above) <br />Title: <br />Address: <br />Employer: <br />City: <br />State: <br />Zip Code. <br />Email: <br />Phone: <br />Fax: <br />Relationship to project location: <br />(owner, manager, CTR coordinator, program partner, etc.) <br />Are you an employer /business? <br />Would you like assistance developing a program? <br />Are you interested in installing a bike rack at your work site or business? <br />PROJECT DESCRIPTION (Attach additional pages if necessary) <br />• What will be implemented or purchased? <br />• What are the goals for the project? <br />• How will the project be evaluated? <br />• Is this part of an existing program or a planned project that needs funding? <br />• Will the project require maintenance after installment? If yes, please describe the maintenance plan. <br />• Project timeline (must be complete by June 2018) <br />