Project Intake and Data Sheet

The following information is being provided to program partners for informing their processes and procedure associated with the referenced, target, or affiliated project(s) or project portfolios. Please treat all information as confidential.

Project Owner or Sponsor Information

Org Name(1):

Address(1):

City/State(1):

Service Area(1):

Business/Sector:

Contact(1):

Title(1):

Phone Number(1):

Email(1):

Website(1):

Program Project Manager / Strategic Partner

Org Name(2):

Address(2):

City/State(2):

Market/Area:

Discipline:

Contact(2):

Title(2):

Phone Number(2):

Email(2):

Website(2):

Industry / Sector Information

Name/DBA:

Address(3):

City/State(3):

Service Area(3):

Deliverable:

Business Type:

Title(3):

Phone Number(3):

Email(3):

Website(3):

Project Overview / General Information

General Description:

Primary Goal or Objective:

Planned Impact Area:

Estimated Start Date:

Additional Info:

Initial Strategies or Solutions

S/S #

S/S (1)

S/S (2)

S/S (3)

S/S (4)

Description / Goal

Description / Goal (1)

Description / Goal (2)

Description / Goal (3)

Description / Goal (4)

Partner or Participant

Partner or Participant (1)

Partner or Participant (2)

Partner or Participant (3)

Partner or Participant (4)

Stage

Stage (1)

Stage (2)

Stage (3)

Stage (4)

Project Portfolio or Related Projects

Project

Project (1)

Project (2)

Project (3)

Project (4)

Type / Location

Type / Location (1)

Type / Location (2)

Type / Location (3)

Type / Location (4)

Partner or Party

Partner or Party (1)

Partner or Party (2)

Partner or Party (3)

Partner or Party (4)

Stage

Stage (5)

Stage (6)

Stage (7)

Stage (8)