Grants Application Form

Grants Application Form
Applicant Information
Name of Business
EIN
Name of Person Representative
Position
Years in Business
Business Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Applicant Type

GrantsCommercial LoanOther
Business Classification
Business Email
example@example.com
Nature of Business
Owner Information
Name

First NameLast Name
SSN
Personal Email
example@example.com
Personal Phone Number
Personal Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Certification Statement for Grants Application

I/We hereby affirm that the information provided in this grant application is true, accurate, and complete to the best of my/our knowledge. I/We understand that any misrepresentation, omission, or falsification may result in disqualification from funding or other legal consequences.

I/We acknowledge that the grantor reserves the right to verify the information submitted, including but not limited to conducting background checks, financial reviews, and other due diligence as deemed necessary.

I/We further authorize the grantor to share relevant application details with partner organizations, evaluators, or other entities involved in the review process, solely for the purpose of assessing eligibility and compliance with grant requirements.

By submitting this application, I/We certify our understanding of these terms and our commitment to ethical and transparent disclosure throughout the process.
Signature

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Date Signed

MonthDayYear
Date
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