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Mini-grant Prebate Request

Business Contact Info

Business Name

First Name

Last Name

Address1

Address2

City

State

Zipcode

Phone

Project Information

What is the estimated total cost of your proposed project? Please research the approximate cost before answering. By submitting this response, you acknowledge that: You agree to complete the project as proposed (limited changes or substitutions). You are responsible for covering any remaining expenses not funded by the grant.

Briefly describe the proposed project.

Please provide links to the items, that must be purchased to complete your project:

Please consult with your Green Business Coordinator regarding purchase requirements and restrictions.

Address2 that provide

Please upload a W9:

Click or drag files to this area to upload. You can upload up to 2 files.

W9s can be found here.

Thanks for participating in the mini-grant program. You will need to fill out another form after the project is complete and supply receipts.

If appropriate, please take ‘before and after’ pictures to include with the second form. It’s helps us help others!