Grant Application Form 📄✨
Please complete all relevant sections and prepare your supporting documents.
Application & Eligibility
Submission Date
*
 -
Month
 -
Day
Year
Date
Amount Requested (USD)
*
Date Completed Entrepreneurial Success Strategies Program
 -
Month
 -
Day
Year
Date
Business Identity
Legal Business Name
*
Doing Business As (DBA)
Legal Entity Type
*
Please Select
LLC
C‑Corp
S‑Corp
Sole Proprietorship
Nonprofit
Other
Year Established
*
Business Stage
*
Please Select
Startup
Seed/Development
Growth
Established
NAICS Code
*
To find NAICS code go to https://www.naics.com/search/
Website
Business Location
Street Address
*
City
*
State
*
Postal Code
*
County
*
Mailing Address (if different)
Contacts & Ownership
Primary Contact Name
*
First Name
Last Name
Primary Contact Title
Primary Contact Email
*
example@example.com
Primary Contact Phone
*
Please enter a valid phone number.
Format: (000) 000-0000.
CEO/Director Name (if different from Primary Contact)
First Name
Last Name
CEO/Director Email
example@example.com
Do you wish to disclose ownership demographics?
*
Yes
No
Ownership Demographics Details (optional)
Project & Use of Funds
Total Project Cost (USD)
*
Itemized Use of Funds
*
Project Timeline (Start Date)
 -
Month
 -
Day
Year
Date
Project Timeline (End Date)
 -
Month
 -
Day
Year
Date
Other Funding Sources / Matching Funds
Workforce Impact
Baseline Full‑Time Employment (FTE)
*
Planned Job Creation (FTE)
*
Planned Job Retention (FTE)
*
Projected Full‑Time Employment by End of Calendar Year (FTE)
*
Narrative Responses
Why this grant? In 300 words or less, explain why this grant is important to your business journey
*
0/300
Economic Impact Statement. In 300 words or less, explain what your vision is for the Heart of Wisconsin Community.
*
0/300
Attachments
Business Plan Upload (DOCX/PDF)
*
Upload a File
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of
Supporting Quotes/Invoices
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of
Licenses/Permits (if applicable)
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of
Acknowledgments & Consent
Signature
*
Signature Date
*
 -
Month
 -
Day
Year
Date
Submit Application
Submit Application
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