MHHP Matching Mini-Grant Application Form
Apply for the Madison Heights Hazel Park Chamber of Commerce Matching Mini-Grant. Please complete all required sections.
SECTION 1 - Business Information
Legal Business Name
*
DBA/Doing Business As
Business Type/Structure
*
Please Select
Sole Proprietor
Partnership
LLC
Corporation
Non-Profit
Other
Business Street Address
*
City
*
State
*
ZIP Code
*
Business Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Business Email Address
*
example@example.com
Business Website
Federal EIN/Tax ID Number
*
Michigan Business License Number
Year Business Established
*
SECTION 2 - Applicant/Contact Information
Applicant First Name
*
Applicant Last Name
*
Title/Role at Business
*
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email Address
*
example@example.com
Is the applicant the property owner?
*
Yes - I am the property owner
No - I am a tenant or leaseholder (property owner letter required)
SECTION 3 - Proposed Project Details
Project Title
*
Project Category
*
Digital Presence
Operational Assets
Physical Space
Technology
Project Description
*
How will this project benefit your business and/or customers?
*
Estimated Project Start Date
*
-
Month
-
Day
Year
Date
Estimated Project Completion Date
*
-
Month
-
Day
Year
Date
SECTION 4 - Financial Information
Total Estimated Project Cost
*
Grant Amount Requested (up to 50% max $1,000)
*
Source of Matching Funds
*
SECTION 5 - Supporting Documents Checklist
Supporting Documents Checklist (check all that apply)
Project cost quotes
Proof of Michigan business license
Tax compliance verification
Property owner approval letter if applicable
Technical specifications if applicable
SECTION 6 - Certification and Signature
I certify that the information provided in this application is true and accurate to the best of my knowledge.
*
I agree
I understand that submission of this application does not guarantee funding.
*
I agree
Applicant Signature
*
Date
*
-
Month
-
Day
Year
Date
Printed Name
*
Title
*
Submit Application
Submit Application
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