| Director, PMO | Phone | Fax | |
| Project Manager | Phone | Fax | |
| Objectives | |||
| Scope | |||
| Responsibilities
| |||
| Assumptions | |||
| Constraints | |||
| Major Risks | |||
| Major Milestones | |||
| Approvals: | |||
| Project Manager | Signature | Date | |
| Director PMO | Signature | Date | |
| Vice President | Signature | Date | |
| Stakeholder #1 | Signature | Date | |
| Stakeholder #2 | Signature | Date | |
| Stakeholder #N | Signature | Date | |