Site Needs Information Form


Please fill out as completely as possible.  If anonymity must be maintained, feel 
free to leave certain fields blank as necessary.

NAME
Title
ORGANIZATION
Address
CITY
State/Prov
Country
Postal Code
TELEPHONE
Fax
E-MAIL
Web Site (URL)


Confidential Search?    Yes    No

What is your primary business?    Manufacturing    Service

SIC/NAICS
Your Product or Service?
Total Employees?

In which activities are you directly involved? select all that apply

Describe your role in the site selection process. select all that apply

Will you need a NEW or EXPANDED facility within ...
12 Months   2 Years   3 Years   for future Use?

The facility will be for: select all that apply

Number of employees needed for new facility?

Labor force required at new site? select all that apply

Have you contacted brokerage group(s)? Yes    No
If Yes, who?

Have you contacted site consultant(s)? Yes    No
If Yes, who?

Indicate location(s) of interest:

Total property size needed? (acres)
Total building size needed? (sq feet)
Manufacturing? (sq feet)
Office? (sq feet)
Warehouse/Distribution? (sq feet)
R&D? (sq feet)
Other? (sq feet)

Type of Building?
select one
Preferred Transaction?
select one

Utility Needs?
select all that apply
Transportation Needs?
select all that apply
Other Special Needs?
select all that apply

Do you have surplus property of interest to others? Yes    No
If Yes, describe:

Comments or additional information:


Copyright © 2004 Marshall County Economic Development Council]. All rights reserved.
Revised: July 23, 2004.