SBR Eligibility Questionnaire Region 1

Eligibility

Thank you for your interest in the Region 1 Small Business Revitalization (SBR) Funding. This checklist is intended to help determine whether your business meets the eligibility criteria prior to attending the required Money Smart Training or officially applying for funding. By completing this checklist, you are confirming that you are the business owner or an authorized representative with the legal authority to provide information on behalf of the business. Please note that all eligibility information must be verified with documentation as part of the official application process. Thank you for your interest and we look forward to learning more about you and your business.
Name*

First NameLast Name
Contact Number*
Email*
example@example.com
Demographics *
Business Details
Did the business begin operating before March 3, 2020?*

Yes: I can provide evidence of business activity before March 3, 2020 (invoices, sales, marketing, etc.)No: The business was started atfer March 3, 2020
Business Name*
Website
Most Active Social Media Account Link
Is your business a legally registered, for-profit entity currently operating in the state of Georgia??*

YesNo
The business is based in one of the 15 Region 1 counties:*

BartowCatoosaChattoogaDadeFanninFloydGilmerGordonHaralsonMurrayPauldingPickensPolkWalkerWhitfield
Business Type*

Sole ProprietorshipPartnershipCorporationS CorporationLimited Liability Corporation (LLC)
You certify that the business has fewer than 500 employees*
Does your business have a valid federal tax identification number (EIN), or do you file business taxes using your Social Security Number (for sole proprietors)?*
Financial Readiness

The Small Business Revitalization Grant application requires submission of financial and business documentation to verify eligibility and compliance. At this eligibility stage, applicants are not required to upload or submit documents, but must verify they have access.
I have access to the required financial and business information needed for the official application.*

Valid photo IDCurrent Georgia Secreary of State Certificate of ExistenceI have recent financial documents (tax return or profit/loss statement)I can explain how I plan to use the grant fundsThree most recent business bank account statementsCompleted and Signed W-9
Is the business currently involved in an active bankruptcy proceeding?*

NoYes
Does your business have any unresolved tax issues or active legal disputes?*

NoYes
Eligible Use of Funds

Grant funds may be used only for approved business-related expenses in accordance with program guidelines.
How do you anticipate using grant funds? (Select all that apply.)*

PayrollRent / UtilitiesOperational CostsEquipment/ SuppliesStaff DevelopmentTechnologyMarketing/ Communications
Money Smart Training

The Money Smart Business training is a required part of the Small Business Revitalization program and is designed to help business owners strengthen financial knowledge and prepare for responsible use of grant funds. The training covers foundational topics such as cash flow management, financial planning, recordkeeping, and long-term business sustainability. Completion of the Money Smart Business training is required after eligibility is confirmed and before submitting an official application. This ensures that applicants understand program expectations and are equipped to successfully manage grant funds if awarded.
Do you agree to register and attend the full required 4 Hour Money Smart Business training session?*

YesNo
Which Training would you like to attend?*

February 28, 2026- Cartersville, GA 8:00am-12:00pmMarch 7, 2026- Rome, GA 8:00am-12:00pmMarch 23, 2026- Hiram, GA 6:00pm-9:00pmApril 2, 2026- Zoom 6:00pm-10:00pm
Grant Participation & Reporting Acknowledgment

Grant recipients may be asked to participate in follow-up reporting and engagement activities, including impact reporting and storytelling, if awarded funds.
Please check all that apply:*

I am willing to complete a grant reportI’m open to sharing my story or photos for community impactI am interested in staying connected with NGBBA for future opportunitiesI am interested in staying connected with NWGAMBA for future opportunities
Acknowledgment
By submitting this form, I acknowledge that eligibility confirmation does not guarantee receipt of funding. I understand that I must complete a required Money Smart Business training to fulfill eligibility requirements before applying for funding.*

YesNo
Based on your responses, your business does not currently meet the eligibility requirements for the Small Business Revitalization Program at this time.

However, training and technical support will be offered through your local chamber, and we’ll be sure to keep you informed about future opportunities designed to support your business.

If you believe this result is due to an error, you may review and update your responses.

The SBR Team
Should be Empty:

Eligibility

Business Details

Financial Readiness

Eligible Use of Funds

Money Smart Training

Grant Participation & Reporting Acknowledgment

Acknowledgment