Chamber Cares Grant Program Application

Supporting Local Businesses When They Need It Most

Applicants simply complete the short form below and upload the required documentation. Our team reviews applications on a rolling basis, and approved funds are typically distributed within 10 business days.

Business Information

Business Name(Required)

Business Address

Street Address City State ZIP Code

Business Phone(Required)

Website Address (If Applicable)

Primary Contact Info

Primary Contact Email(Required)

Primary Contact Phone(Required)

Primary Contact Name(Required)

First Last

Incident Information

Date of Vandalism Incident(Required)

Brief Description of Damage (what happened):(Required)

Estimated Cost of Repairs ($):(Required)

Was a police report filed?(Required)

Yes

Police Report Number(Required)

Please attach the following: 1.Photos of the damage, 2. Repair estimate or invoice, 3. Police report (if filed)(Required)

Drop files here or

Max. file size: 20 MB, Max. files: 6.

Grant Information

If approved, how would you like to receive the $500 grant?(Required)

Check

Electronic payment (details will be requested upon approval)

Certification and Signature

Certification(Required)

I certify that the information provided in this application is true, complete, and accurate to the best of my knowledge. I understand that the Chamber may verify this information and that submission does not guarantee approval.

Please enter your full name to sign this form(Required)

Chamber Cares Application

Chamber Cares Grant Program Application

Business Information

Primary Contact Info

Incident Information

Grant Information

Certification and Signature

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Community Information

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