SIDE HUSTLE MICRO-GRANT
Application Form: Please fill out each section. Questions? Contact Wendy Petersen at petersenw@cfwestman.ca
Name
*
Contact Phone
*
Format: (000) 000-0000.
Age
*
E-mail address
*
example@example.com
I certify I am at least 18 years of age
*
Please Select
Yes
No
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
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Agreement
Applicants under the age of 18 must have a legal guardian to sign off on their application
I have a legal guardian who will be supervising my Side Hustle Program and funding
Yes
No
Not Applicable
Name of Legal Guardian
Contact of Legal Guardian
Check all identities that apply to you:
I am Indigenous
I am a person with disability
I am a Canadian Citizen/ Permanent Resident
I am a newcomer to Canada (In Canada for less than 2 years)
I am an immigrant in the Westman Region (In Canada for more than 2 years)
Gender
Please Select
F—female
M—male
X—another gender
Business Info
Registered or Proposed Business Name
*
Business Description: Tell us a few details about your business idea - how will it work?
*
Business location and/or site(s) of operation
*
What will your requested funds be used for?
*
Amount requested from Community Futures Westman (up to a max of $500)
*
If your request is succesful, please indicate who the cheque should be made payable to:
*
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Business Support
Amount you are contributing to the business (such as cash or previous purchases towards your business idea, please explain if applicable):
Would you require additional funds in the form of a loan through Community Futures Westman to finance your business/ business idea? (Community Futures Westman can finance up to $150,000 to a single business)
*
Yes
No
If Yes, may we share your contact with our Business Analyst?
Yes
No
Tell us where you heard about the Side Hustle Program?
Facebook
Word of Mouth
Organization, Counselor, worker
Poster
Newspaper
Other
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Agreement
(By checking these boxes you are agreeing to our terms - should you have any questions please contact us)
Agreement and Terms
*
I agree to use the grant only for the purposes described in my application.
Agreement and Terms
*
I agree to participate in any required mentoring, check-ins, or training sessions.
Agreement and Terms
*
By signing this application, I confirm I have read and understood the Side Hustle Program guidelines. If approved, I agree to enter into a formal Funding Agreement with CFWestMan.
Digital Signature Name
*
First Name
Last Name
Digital Signature Date
-
Month
-
Day
Year
Date
Please verify that you are human
*
Submit
Should be Empty: