JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Municipal Energy Resilience Program
Need more info first? Check out the website:
Learn More Here!
This form is not binding and can be filled out multiple times- the purpose is to support communication with CVRPC as we are here to support your applications and project development.
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
Town:
*
Your answer
What is your role:
Municipal Staff
Selectboard
Planning Commission
Town Energy Committee/Coordinator
Other:
Have you spoken about the Municipal Energy Resilience Program with (choose all that apply):
Municipal Staff
Selectboard
Planning Commission
Town Energy Committee/Coordinator
Other:
Please provide a brief list of your municipal buildings (+address) and for each one please describe: current known issues, updates (past and planned), and who uses the building! If a building is in DIRE condition please describe. The more detail the better but at the very least a list of all municipal buildings/facilities and addresses will suffice!
Your answer
Please note your top three priority buildings for an assessment and thus to apply for project funds (and if you have a quick reason why- big emissions and cost savings, immediate need, opportunity with other projects in progress, etc):
Your answer
Please note an known issues with ADA compliance, hazardous materials, location in the floodplain, etc.
Your answer
Would you like support from CVRPC to pull together a more formal building inventory and applications?
Yes
No
Maybe
Clear selection
Are you interested in the optional $4000 community grants as well? If so, do you have an idea how you'd like to use it?
Your answer
A copy of your responses will be emailed to the address you provided.
Submit
Page 1 of 1
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
Privacy
Terms
This content is neither created nor endorsed by Google.
Report Abuse
-
Terms of Service
-
Privacy Policy
Forms