• Grant Application for Technical Assistance

    2024 - 2025 For businesses with fewer than 20 employees

  • Please note: All questions on this application are required in order to meet our funder’s compliance guidelines. If you need assistance, clarification, or have questions about any section, please don’t hesitate to reach out. Contact our Program Coordinator: Lindsay Aucoin, at 413-497-4409 or Lindsaya@qvcdc.org — We're here to help!

  • Date*
     / /
    2 digit month, 2 digit day, 4 digit year
  • Format: (000) 000-0000.

  • Please note: All questions on this application are required in order to meet our funder’s compliance guidelines. If you need assistance, clarification, or have questions about any section, please don’t hesitate to reach out. Contact our Program Coordinator: Lindsay Aucoin, at 413-497-4409 or Lindsaya@qvcdc.org — We're here to help!

  • Business Income Information:

  • Business Status*
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  • Current Federal Taxes For All Family Members Must Be Submitted To Confirm Income

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  • Please note: All questions on this application are required in order to meet our funder’s compliance guidelines. If you need assistance, clarification, or have questions about any section, please don’t hesitate to reach out. Contact our Program Coordinator: Lindsay Aucoin, at 413-497-4409 or Lindsaya@qvcdc.org — We're here to help!

  • Technical Assistance Information

  • Are you applying for:*

  • What is the goal for taking this class or working with a 1:1 consultant? Please check all that apply.

  • Business Planning & Strategy*
  • Referral source:*

  • Please note: All questions on this application are required in order to meet our funder’s compliance guidelines. If you need assistance, clarification, or have questions about any section, please don’t hesitate to reach out. Contact our Program Coordinator: Lindsay Aucoin, at 413-497-4409 or Lindsaya@qvcdc.org — We're here to help!

  • Demographic Information

  • The following questions are used for funding reporting purposes. Any information you provide is sent to our funders anonymously.

    QVCDC does not include any personally identifying information in our reporting, all answers are kept confidential.By answering completely and honestly, we are able to best help our local community and accurately represent the people we serve.

    Providing this information to our funders helps secure funding for our initiatives.

  • Gender*
  • Do you have a disability?*
  • If female, are you head of household?*
  • Are you 60 or more years of age?*
  • Are you a Veteran?*
  • Do you identify as LGBTQ?*
  • Race/Ethnicity: How would you describe yourself? Check all that apply.*

  • Contract Agreement

  • Please Initial on each line below: I understand that all information provided by the QVCDC or an independent consultant may be accepted or rejected at my discretion at any time. I agree to hold the Quaboag Valley CDC (QVCDC), any third-party representative and/or independent consultant harmless against any liability, loss or damage cause by or arising from the use of any and all information or materials furnished by the QVCDC, representative and/or independent consultant in connection with my participation therein.*
  • I certify that all of the information provided in this applicationis true and correct to best of my knowledge. I further understand theinformation that I provide may be verified by a third party and it may be usedto determine eligibility for program services.*
  • I certify that I am over 18 years of age, that I agree to the terms and conditions of this application and that I am responsible for ensuring that the work for which I may be deemed eligible is completed in a timely manner.*
  • By submitting this application, I agree to provide QVCDC and its funders with follow-up reports and/or surveys about my business.*
  • I give my permission to the Quaboag Valley Community Development Corporation (QVCDC) to use my name, the name of my business/organization, and/or my picture or a picture of my business or organization for the purpose of promoting their programs, reporting on their programs, or securing additional funds for their programs.*
  • QVCDC does not certify consultants however we do require that consultants show proof of competency when applicable such as a license or certification.*
  • Date*
     - -
    2 digit month, 2 digit day, 4 digit year

  • Release Form

  • The undersigned hereby consents to the use of my name, the name of my business/organization, the participation in interviews, the use of quotes and the taking of photographs or videos or any other media (collectively, the "Materials") by the Quaboag Valley Community Development Corporation & Quaboag Valley Business Assistance Corporation, their advertising agency, and all of their agents, designees and assignees (collectively, the "Designees") for the purpose of promoting their programs, reporting on their programs or securing additional funds for their programs.

    I also grant to the Quaboag Valley Community Development Corporation & Quaboag Valley Business Assistance Corporation and the other Designees the right to edit, use and reuse said Materials for any purpose, including the use in print, on the internet and all other forms of media and social media including Facebook and all other commercial advertising. I also hereby release the Quaboag Valley Community Development Corporation &Quaboag Valley Business Assistance Corporation and its agents and employees and all other Designees from all claims, demands and liabilities whatsoever in connection with the above.

  • Date*
     - -
    2 digit month, 2 digit day, 4 digit year
  • Should be Empty: