JCEDC Small Business Development Grant (JC-SBDG) Application - Round 2: Patents and Registrations Support)

JCEDC Small Business Development Grant (JC-SBDG) MicroGrant Application: Round 2 - Patents and Registrations

For this application "Patents" includes: patents and registrations such as servicemarks, trademarks and copyrights. You will need to complete this online application in one sitting as you cannot save it and login later. Please answer all questions that apply (red asterisk indicates required). Only complete applications will be considered.
Applicant/ Point of Contact Information
Applicant/ Point of Contact Name*

First NameLast Name
Applicant/ Point of Contact Email Address*
example@example.com
Applicant/ Point of Contact Phone Number*
Please include area codeFormat: (000) 000-0000.
Patent Owner Information

Fill out the questions according to whether the patent owner is an individual or a business.
Individual/Business Name*
Entity may be formally registered or not
Business Entity Type*
Business Legal Type*
Individual/Business Email*
example@example.com
Individual/Business Phone*
Please include area codeFormat: (000) 000-0000.
Business Website
If Business, Year Established
Individual/Business Physical Address*

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Individual/Business Mailing Address*

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Business Stage*
Business Industry*
Briefly describe products and/or services the business offers (Leave blank if individual)
Excluding owner(s), partners, and contractors, how many FTP employees does business have today? (Leave blank if individual)
FTP: Full Time Permanent (30 or more hours/week scheduled or worked on average year-round)
Excluding owner(s), partners, and contractors, how many PTP employees does business have today? (Leave blank if individual)
PTP: Part Time Permanent (less than 30 hours/week scheduled or worked on average year-round)
Excluding owner(s), partners, and contractors, how many FTT employees does business have today? (Leave blank if individual)
FTT: Full Time Temporary (30 or more hours/week scheduled or worked on average)
Excluding owner(s), partners, and contractors, how many PTT employees does business have today? (Leave blank if individual)
PTT: Part Time Temporary (less than 30 hours/week scheduled or worked on average)
Business Ownership

If multiple owners, the sum of all owners' percentages must total 100% (Leave blank if individual)
Business Owner #1
Business Owner #2
Business Owner #3
Business Owner #4
Use this space to add additional ownership information, if needed
Your Patent Information
Briefly describe your patent. FOR YOUR PROTECTION: Only describe the PROBLEM IT SOLVES not HOW it is solved.*
Describe how this project will positively impact the Local and/or Juneau County economy (if awarded)*
Supplier Information for Your Patent

For each supplier you intend to use.
Grant Amount Requesting (Max., $4,500 for patents)*
Supplier #1*
Use this space to add additional supplier info, if needed.
Supplier Information for Continuing Education

For each supplier you intend to use.
Grant Amount Requesting (Max., $500 for continuing education)*
Supplier #1*
Use this space to add additional supplier information if needed.
Full Patent Project Data

This requested grant amount may be only part of a larger project cost, or it may be the entire project cost. Please share details.
Total Patent Project Cost*
Remaining patent project cost after amount is awarded*
If project cost is the same as requested grant amount, enter zero
If total patent project cost is greater than this requested grant amount, please list all other funding sources and amounts that will meet the need.
Will this patent project receive any donated products or services? If so, please describe.
Other Information
Has this business received any grant funding in the past 5 years (federal, state, local, or other)? If so please describe what, when, and how much.*
Answering Yes to this question does not disqualify you from being considered.
Has this business or any of its owners declared bankruptcy? If so, please briefly describe who, what and when.*
Answering Yes to this question does not disqualify you from being considered. All application information will be kept CONFIDENTIAL and only non-personally-identifying aggregate summaries will be reported back to the grant underwriters.
Please describe how involved the business and/or it's owners are in the local community and/or Juneau County. Include examples or details such as what, how often, dollars donated, hours volunteered, etc.*
I hereby certify that all the above information in this grant application is true and correct to the best of my knowledge. I understand that any instance of misrepresentation may result in my disqualification from receiving this or future grant funds and/or may necessitate my REPAYMENT of any grant funds received. Furthermore I understand that (a) submitting this application is not a guarantee of award, (b) the decision of the JC-SBDG Committee is final, and (c) the JC-SBDG Committee will not only consider all relevant information from this application but will also strive to allocate awards throughout all communities in Juneau County and to as many industries as possible. In addition I consent to the JC-SBDG Committee's (a) sharing of my voluntarily disclosed data in aggregate, non-personally-identifying ways, to this grant program's underwriter, and (b) utilization of any award photographs or statements for media or promotional purposes. Personal and specific information for all businesses and owners shared here will be kept STRICTLY CONFIDENTIAL. Email addresses will be maintained by JCEDC but their owners will have the right to unsubscribe at any time.
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JCEDC Small Business Development Grant (JC-SBDG) MicroGrant Application: Round 2 - Patents and Registrations

Applicant/ Point of Contact Information

Patent Owner Information

Business Ownership

Your Patent Information

Supplier Information for Your Patent

Supplier Information for Continuing Education

Full Patent Project Data

Other Information