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2. 
3. Capital Improvement Planning Document FY 2026
5. Department*
6. Staff Member Leading Project/Request *

   Name of Project Leader

7. Phone Number*
9. Email Address*
11. Project Duration (until completion)*

    Select the duration that applies:

    1. 1 year
    2. 2 years
    3. 3 years
    4. 4 years
    5. 5 years
    6. 6 years
    7. 7 or more years
12. Description of Project *

    In a few sentences explain the need for this project and any crucial details to be considered.

14. Please indicate the amount of funding needed for each year. Please use this formatting for funding allocations:

    ex. $5,000

    ex. $10,000

16. Funding Request for FY 26*
18. Funding Request for FY 27*
20. Funding Request for FY 28*
22. Funding Request for FY 29*
24. Funding Request for FY 30*
26. Please upload any support documentation you have for this project.

    Please combine all your support documents in PDF for single upload. 

28. This project requires collaboration with the following departments and agencies:*

    Check all that apply to this project. 

    1. County Administration
    2. Public Works
    3. Public Safety
    4. Economic Development
    5. Community Development
    6. Schools
    7. IT
    8. Public and Employee Relations
    9. Management Services
    10. Youth Services
    11. Library
    12. Recreation
    13. CCUSA
    14. Town of Altavista
    15. Town of Brookneal
    16. Extension Office
    17. Other
29. Time Line *

    Please upload a time line document that conveys the key points of development,  implementation.  and completion.

31. Please list any additional information that County Administration or the Board need to know regarding this project/timeline.*

    Please discuss any forward movement, set backs, changes, etc. that may affect the scope of this project over its duration. 

33. Electronic Signature
Leave This Blank:


35. 1. Receive an email copy of this form.
36. Email address

    This field is not part of the form submission.

37. Submit

* indicates a required field