Main Street Connected Grant Application

Applicant Information

Downtown Business Location

Business Information

Business Name

Business Address

Contact Name

Contact Email

Contact Phone

Website

Business Stage

Number of employees

Business Entity Type

Business Industry - please select one

Please specify

Project Funding and Schedule

Total Project Cost

(Cannot exceed $5,000)

Grant Request Amount

(50% match up to $2,500)

Is this project part of a larger improvement or initiative?

Please provide the estimated costs.

I acknowledge that grant awards are provided as reimbursement, and I must submit receipts of completed work before grant monies are dispersed. I also acknowledge that projects must not deviate from the use being proposed in this application.

Project Start Date

Project Completion Date (Must be completed within six months from grant award)

If awarded, for 30 days after receiving the reimbursement grant, I agree to acknowledge MSU Federal Credit Union at promotional events related to the funded project and to prominently display a 11-inch x 17-inch graphic supplied by Main Street Oakland County that promotes MSU Federal Credit Union and Main Street Oakland County.

Project Description

Describe in detail the proposed use of grant funds. Applicants must describe the intended use of funds and how it will contribute to the success of the business. Vague descriptions regarding the use of funds will not be accepted.

Please attach all documents that verify the use of funds.

Documents may include contractor estimates, drawings, marketing plans, website design plans, etc.

Upload Document

Committed Funding and/or Match Dollars

150 words or less. (Note: Match dollars are a reimbursement for completed work)

Acknowledgement

I / We certify that all information set forth in this application is a true representation of the facts pertaining to the subject project/property/program for the purpose of obtaining funding under the Main Street Connected Grant Program. I understand and acknowledge that any willful misrepresentation of the information contained in this application could result in disqualification from the program, requiring any funds already disbursed to be repaid in full. If a determination is made by overseeing staff that program funds have not been used for eligible program activities, the Applicant agrees that the proceeds shall be returned, in full, and acknowledges that, with respect to such proceeds so returned, he/she shall have no further interest, right, or claim. It is understood that all funding commitments are contingent upon the availability of program funds.

The applicant further certifies that he/she has read, understands, and has signed the MAIN STREET CONNECTED GRANT PROGRAM AGREEMENT.

Signature (Your typed name is acknowledgement of the above terms)

Title

Date