Hardship Assistance Grant Application

Hardship Assistance Grant Application

Please complete this form to apply for the Hardship Assistance Grant. Provide detailed and accurate information about your business and the project for which you are seeking funding.
Business Name*
Owner(s) Name(s)*
Business Address*

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Email Address*
example@example.com
Website
Social Media Links (e.g., Facebook, Instagram, LinkedIn)
Type of Business/Industry*
Years in Business*
Number of Employees*
YesNo
YesNo
Project Overview: What specific project or initiative will this grant fund?*
Total estimated cost of this project (USD)*
How much funding are you requesting (USD)?*
YesNo
Preferred completion date for the project*

MonthDayYear
Date
Have you secured other funding sources? If so, please specify.
Should be Empty: