FUEL Program Reimbursement Eligibility & Application

FUEL Program Reimbursement Eligibility & Application

EIP is an incentive program that provides monetary reimbursement up to $1,800 over 12 months to new entrepreneurs & small business owners to help fund the costs of critical early-stage business development tools. Interested founders must submit an application for the program. Applicants who meet the eligibility requirements, including active participation in the FUEL Program with an assigned mentor team, will be reviewed for approval.
Eligibility Requirements

• Current & active mentee in the FUEL PROGRAM • Ability to fund applicable costs before applying for reimbursement • Ability to provide official documentation of expenses incurred at the time of request for reimbursement • Ability to provide basic financial data for new venture/business on a regular basis (revenue, expenses and profit (or loss)) • Ability to complete all applicable milestones within 12 months of application approval • Only eligible expenses will be reimbursed — expenses incurred during the 12 month period and only for the items in the reimbursement table above
Do you meet all of the eligibility requirements listed above?

Other, please explain
Full Name

First NameLast Name
Business Name
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
Business Start Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Tax ID / EIN / Business Registration Number (if applicable)
Type of Business

Other: Please explain
Industry Sector
How long have you been in the FUEL program?
Signature
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Should be Empty:

FUEL Program Reimbursement Eligibility & Application

Eligibility Requirements