2. The deadline for this grant application is August 31, 2023
4. Company Name*
6. Type of Business*
8. Business Address*
10. City*
11. State*
12. Zip Code*
14. Phone Number*
15. Fax Number
17. Applicant's Name*
19. Applicant's Title*
21. Applicant's Email Address*
23. Applicant is:*
    -- Select One --Property ownerBusiness ownerOther
25. How long has the business been at the current location?*
26. When does your current lease expire?*
28. Estimated Project Cost*
29. Estimated Project Completion Date*
    Estimated Project Completion Date
31. Total grant amount applied for*
33. Property Owner's Contact Information (If different from Applicant)
    Please Note: If you are not the property owner, the property owner must co‐sign the memorandum of understanding before your application will be considered. 
35. Name
36. Email Address
38. Address
40. City
41. State
42. Zip Code
44. Phone Number
45. Fax Number
47. The following must accompany this application:  A clear description of the improvement to be made (before picture if applicable) and at least (2) bids on the work about to be performed.
49. A copy of the Memorandum of Understanding MUST accompany your application. Please download, sign and attached to this application form.
    Please Note: If you are not the property owner, the property owner must co‐sign the memorandum of understanding before your application will be considered. 
51. Business Grant Program Memorandum of Understanding
    Memorandum of Understanding
53. Photos, sketches and bids.*
55. Full Project Description*
57. Electronic Signature Agreement

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

    1. I agree.
59. Electronic Signature
Leave This Blank:


61. 1. Receive an email copy of this form.
62. Email address

    This field is not part of the form submission.

63. Submit Submit and Print

* indicates a required field