* indicates required field
Farm Business Name *
Farm Business Address *
City *
State *
Zip code *
Mailing Address (if different)
City
State
Zip code
Farm Owner *
Farm Contact Person *
Email Address *
Telephone *
Cell phone
Best time to call *
Best way to reach you *
Email Telephone Cell phone
Is your project in a rural eligible area? *
Yes No
Are you an agricultural producer? *
Are you a Small Rural Business? *
As an agricultural producer, did you produce agricultural products with a gross market value of:
Less than $600,000 in the preceding year? *
Less than $200,000 in the preceding year? *
Are you a Very Small Rural Business (As defined in 4280.103 - a business with less than 15 employees and less than $1 million in annual receipts)? *
Have you applied to the RD grant program before? *
If yes, was your project funded?
Have you attended a Rural Development Informational Session or Application Workshop for the energy program? *
Does your project have any environmental, historical, or critical habitat impacts? *
Yes No Unknown
If so, have you contacted relevant agencies?
Have you completed an energy audit or renewable energy assessment for the proposed project? *
If yes, please list:
Total project costs ($)
Total project savings ($)
Projected life of the improvement or system (years)
Is the project site located on any kind of agriculturally preserved and restricted land such as Agricultural Preservation Restriction (APR) land? *
Do you have a plan to finance, maintain, and operate this project through its lifetime? *
Describe any matching funds or cost-share from other sources (include funding organization and funding - % or dollar amount):
Energy Efficiency Improvement or Renewable Energy System? * Select one Energy Efficiency Improvement Renewable Energy System
What type of project? * Select one Small Energy Efficiency Small Photovoltaic Small Biomass Small Solar Thermal Small Wind Other
Description of your project, including a brief summary of any audits or assessments completed, site information, any potential impacts on the environment, historical or critical habitat areas, permitting requirements, equipment and installer information, timeframe for completion, funding, etc. (Please provide us enough information to ascertain your readiness to apply to the program in March 2008, your project has technical merit, you can fund and maintain the project, and you are motivated to implement.) *
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