Initial Project Information Form

Principal Contact Information

Name Date
Phone E-mail
Role: Consultant Company Representative Community Representative
Title Company name
Address City, State, Zip
Have you spoken to anyone in our office? If so with whom?
Your role on behalf of the company:
Notes:

Specific Project Information

Industry Description NAICS
Current Location  
New TX employees projected by year:
Yr 1:
Yr 2:
Yr 3:
Yr 4:
Yrs 5-10:
Total:
Job Type: Professional: % of workers Average wage
  General: % of workers Average wage
  Ownership: Private Public
Est. Total Private Investment $ Is financing for entire project secured? Yes No
Immediate Parent Company Ultimate Parent Company
Briefly describe type of assistance you are seeking:
Select all that apply:
Consolidation Expansion, new location Expansion, existing location
Fabrication/Assembly Service Industry Relocation
     from
Headquarters Start-up company Other
Geographic region of interest: Regions Map
Initial site visit expected
Prelim decision date
Final decision date


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