Greenville-Pitt County Chamber of Commerce: Grant Program Form

Lifting Up Small Business in Greenville-Pitt County Grant Application Form

Please complete the application form below in its entirety. All of the questions below are required. An incomplete application form will not be given consideration for selection.

Business Name (if you have a DBA, please include it in the answer below):
Business Name:
Primary Business Address:
Address:
City, State & Zip:
Primary Contact for Application (at least a 50% owner of the business entity):
Primary Contact:
Email:
Phone:
Business Website/URL (if none, please write N/A):
Website:
How long has your business been in operation?
Business Operating:
Number of full-time employees:
Employees:
Please describe your business and the products or services it offers in two to three sentences:
Q1:
How will your business utilize the grant money?
Q2:
How will your proposed plan support the community where your business primarily operates?
Q3:
Please upload the following documents:
Company Bio
Company Logo
Exterior Photo of Business
Business Owner Headshot
Submit Form:

Payment

Credit Card Type

Name on card

Billing address

City / State / ZIP

Card number

Expiration date

Security code

Business Name (if you have a DBA, please include it in the answer below):

Primary Business Address:

Primary Contact for Application (at least a 50% owner of the business entity):

Business Website/URL (if none, please write N/A):

How long has your business been in operation?

Number of full-time employees:

Please describe your business and the products or services it offers in two to three sentences:

How will your business utilize the grant money?

How will your proposed plan support the community where your business primarily operates?

Please upload the following documents:

Payment