Non-Profit Example | California Small Business COVID-19 Relief Grant Program

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First Name
Last Name
E-Mail
Confirm E-Mail
Owner Cell Phone
Confirm Owner Cell Phone
Business Name
Zip Code of Business
Consent
I accept the SMS/Text Policy
Owner details (authorized representative of the non-profit)
Owner First Name
Owner Last Name
Email
Phone
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Owner Date of Birth
MM slash DD slash YYYY
Owner Social Security (#SSN)
% of Ownership
Consent
I accept the Terms and Conditions
Business Information
Business Name
DBA (Doing Business As)-[ Note -If no DBA type NONE ]
Business EIN (Only digits, Cannot contain Special Characters or Spaces)
Business Phone #
Business Type
State of Incorporation
State / Province / Region
Business Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Date Business Established
MM slash DD slash YYYY
Business Website URL
How can we help you?
Purpose of grant
Amount Requested
Will This Grant Create More Jobs?
Annual Revenue
# of Full-Time Employees
# of Part-Time Employees
# of Jobs to be Created (during 2020)
# of Jobs Retained
Business demographics
Who is your customer base?
What does your business do?
What type of business is it? *
Tell us more.
NAICS Code
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Woman Owned Business
Veteran
Disabled
Race
Ethnicity
Franchise
Rural
Disclosures
At least 25% of the non-profit’s revenues are derived from services in the following categories - food security, housing security, childcare, workforce development.
During the last 9 months, has the non-profit received any COVID-19 related emergency funding?
If YES, what was the name of the program in which you received funding?
If YES, what was the total amount of relief funds have you received to date?
The non-profit was in operations on or before June 1st, 2019.
The nonprofit serves >51% of clients that identify as low-to-moderate income, based HUD household income guidelines for California.
What was the gross revenue for the non-profit for April 1st, 2019 - September 30th, 2019?
What was the gross revenue for the non-profit for April 1st, 2020 - September 30th, 2020?

This is a sample application for translation viewing only.

This is not an application and you cannot use this to apply.

Let's get started with your application

Owner details (authorized representative of the non-profit)

Business Information

How can we help you?

Business demographics

Disclosures

This is a sample application for translation viewing only.

This is not an application and you cannot use this to apply.