Storefront Revitalization Grant Program

Name of Applicant:

Address of Applicant:

Email Address:

Telephone number (days):

Telephone number (evenings):

I am:

MBE Certified Business

WBE Certified Business

Service Disabled Veteran-Owned Small Business

N/A

I am the:

Building Owner

Building Tenant

Deed (if owner) or Lease (if tenant) (3MB file size Maximum)

Building Owner Consent (if tenant) (3MB file size Maximum)

Certification of MBE / WBE / SDVOB / or NA (if none) (3MB file size Maximum)