Application for Downtown Jeffersonville Small Business Recovery Grant
RequiredRequired Question(s)
Please enter the information indicated below.

First Name:
Last Name:
Job Title:
Company Name:
Work Phone:
Email Address:
emailaddress@xyz.com
Address 1:
Address 2:
City:
State/Province
(US/Canada):
Postal Code:

Names of all business owners:
 

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Required
Select Business Type:
Retail
Restaurant or Bar
Personal Care
Required
Year Business Opened in Jeffersonville:
 

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How many full-time employees (including owners) are employed by the business?
 

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Required
My business was forced to close as a direct result of the COVID-19 emergency.
Partially
Wholly
Required
What is the amount of grant funding you are applying for ($3,000 is the maximum)?
 

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 I would like to use the grant funds for (check all that apply):
Development of an e-commerce website
Rent/Mortgage
Utilities
Other  
Additional Comments?
 

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A Downtown Jeffersonville Small Business Recovery Grant is subject to availability of approved, appropriated funds.
 
In order to be eligible for Jeffersonville Main Street's Downtown Jeffersonville Small Business Recovery Grant, applicant agrees to the following:
1. Applicant must be an independently-owned, bricks and mortar retail, restaurant, or personal care business with under 25 employees operating in Jeffersonville, Indiana, and located within the grant program's designated target area of the Jeffersonville Urban Enterprise Zone.
2. An eligible business cannot be part of a national retail or restaurant chain.
3. An eligible business must have been closed or partially closed during normal business hours under Indiana Governor Holcomb's Declaration of Public Health Emergency for COVID-19.  
4. Applicant must have already applied for SBA Economic Injury Disaster Loan or will apply within 30 days of being awarded a Downtown Jeffersonville Small Business Recovery Grant.
5. Applicant must have already applied for the federal government's Paycheck Protection Program or will apply within 30 days of being awarded a Downtown Jeffersonville Small Business Recovery Grant.
6. If Grant Awardee has multiple locations including site(s) outside of downtown Jeffersonville, all grant funds from the Jeffersonville Small Business Recovery Grant must be used in association with a downtown Jeffersonville business location.
7. Businesses that close or relocate within 12 months of being awarded a Downtown Jeffersonville Small Business Recovery Grant will be required to repay the grant award in full to Jeffersonville Main Street, Inc.
 
By typing my name and entering my initials, I hereby certify that I intend this to be my true and legal signature, thus averring that all statements given in this form are true and accurate to the best of my knowledge and belief, and that I agree to be bound by the provisions of this grant agreement, including repayment upon default.
 
Applicant First and Last Name:
 

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Applicant Initials:
 

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Date:
 

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