Forms • Northwest Regional Planning Commission, WI • CivicEngage

Date Requested (DD/MM/YYYY)*

Date Needed (DD/MM/YYYY)*

Project Name*

Name*

Organization Name*

Street Address

City

State

Zip Code

Phone/Ext

Fax

Email*

Website

Contacted How?

	By Phone
	Email

	In Person
	In Writing

Request For

	Site Selector
	Business

	In-House Use
	Other

Describe (NAICS Code, Business Type, Etc.)*

Target Geography*

Details of Target Geography*

Time Frame of Requested Data (Indicate years between 2001-2022)

Identify in Detail the Request/Other Info/Instructions*

Products/Profiles Desired

Economy

	Industry
	Occupation

Demographic

Education

	Program Completions
	Job Openings

Training Gaps

Input/Output

Industry Expansion/Contraction

Business Opportunity

Workforce

Compare Jobs

Knowledge & Skill Concentrations

Details of Products/Profiles Desired

Sensitivity of Project*

Confidential

Non-Confidential

Report Formats

	MS Excel
	PDF

MS Word

* indicates required fields.

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