Business Information Form

First Name

Last Name

Phone

Business Phone

Email Address

Business Address

Apartment, suite, etc

City

State/Province

ZIP / Postal Code

Are You a VeteranYesNoPrefer Not to Specify

Are You DisabledYesNoPrefer Not to Specify

Owner's GenderMaleFemalePrefer Not to Specify

Website

Do you have an active Employer Identification Number (EIN) or Business Number (BN)? Please note that one of these is required for grant eligibility. *

Legal Business Name

DBA (Name)

Have You Received a Grant Before

Business Annual Gross Income

Requested Funding Amount

Which One Applies to You?

What is your business type?

Tell us about your organization and how it helps the community. This will help us understand your goals and needs better.

Upload file

Do you understand that these grants require document preperation? *Yes

Do you give us authorization to do your document preperation for you? *Yes

Employer Identification Number (EIN) – USA

Business Number (BN) – Canada

Signature *

New Client Onboarding Form

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