Capital requests from the PEG fund are limited to organizations within City of Dubuque limits or to those organizations with a principal meeting place within city limits.

Organization Name:*

Address:*

City:*

State:*

Select a StateAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMassachusettsMarylandMichiganMinnesotaMississippiMissouriMontanaNorth CarolinaNorth DakotaNebraskaNevada New Hampshire New JerseyNew MexicoNew YorkOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVirginiaVermontWashingtonWest VirginiaWisconsinWyomingWashington D.C.

Zip Code:*

Organization Contact:*

Email Address:*

Telephone Number:*

Fax Number:

Total Amount Requested:*

Provide a general description of what you are requesting and why:*

Describe how the community will benefit from your request:*

Item #1:*

Price:*

Item #2:

Price:

Item #3:

Price:

Item #4:

Price:

Item #5:

Price:

Item #6:

Price:

Item #7:

Price:

Item #8:

Price:

Item #9:

Price:

Item #10:

Price:

Additional Items/Comments:*

Please attach all applicable quotations:

Please submit your application at least five (5) business days before the next scheduled Cable TV Tele-Programming Commission meeting.