LISC Small Business Grants Application

This application form captures preliminary information for a business seeking a Small Business Grant. Before proceeding, LISC recommends that respondents read the online FAQ for more information about this round of the Small Business Grant Program.
Terms and Conditions

Applicants may apply once for this round and for one business only. For business owners with multiple businesses, please complete this application based on your largest business owned. Each grant is limited to one grant per individual and business tax ID. To qualify for this program, business owners must be at least 21 years of age. Awards will be made to qualified businesses, and eligibility is based on accurate and complete submission.

The program will focus on serving businesses based in historically under-served areas who may not have access to flexible, affordable, capital and that create quality jobs, businesses that have a high community impact, and businesses led by entrepreneurs of color and women. 

If your business is selected as a finalist, you will be notified via email. Being selected as a finalist does not guarantee a grant will be awarded. As a finalist, additional documentation will be required, including date of birth, SSN, TIN/ITIN and/or EIN for the applicant and/or the business in order for us to perform the due diligence required by the program’s funding source. This due diligence inquiry may include a background verification that we will conduct at our expense. If the due diligence step is successfully completed, we will ask for W-9 and appropriate banking information so that we may transfer funds by ACH to your designated account. If your W-9 and banking information does not match your application, you may be ineligible to receive grant funds. 

Privacy: Information provided through the application process is the responsibility of each applicant. Applications submitted to the portal remain confidential to the general public and any fellow applicants. Applicants will not hold LISC, the program funder or either of their respective affiliates, and/or their affiliates’ respective members, partners, officers, employees, and agents liable for any losses, damages, costs, or expenses of any kind relating to the use or the adequacy, accuracy, or completeness of any information loaded in the form. For further information please see LISC’s privacy policy. Data entered on this secure form utilizes FormAssembly.  More info.

Conflict of Interest: Current directors, officers, employees and contractors of Anheuser-Busch, the Social Change Fund United, LISC or such individuals' family members (spouse, parents, children, grandchildren, great-grandchildren, and spouses of children, grandchildren, and great-grandchildren) may not be eligible to receive an award. 

Publicity: If awarded, please be advised that the business/applicant’s application information, name, statements, and other information provided during the award process may be used for promotional purposes in all forms and media and the business/applicant may be contacted by LISC and/or the program sponsors for such purposes. Applicant grants to LISC and the program sponsors a perpetual license to use such information without additional compensation (except where prohibited by law), and without any right to review and/or approve such content. Until notified, applicants must agree not to share any status as a finalist publicly, including but not limited to all social media platforms, news media, or local publications.

Monitoring: LISC may monitor and conduct evaluation activity funded by the LISC Small Business Grant. This might involve a review of quantitative or qualitative data needed to understand the impact of the fund.

Submission Guidance: LISC cannot accept changes to your application once it has been submitted, so please review it carefully. Your work may not be saved if you leave the web page before submitting the application. You may also lose your work if your internet is disconnected, or as a result of other potential web browser issues. 
 
You will see a confirmation page after successful completion of this application.


Applicant Information

Please be ready to provide information for the lead business owner.
Business Information 
Please note: small business owners may apply for one business only. For business owners with multiple businesses, please complete this application based on the largest business owned. Each grant is limited to one grant per individual and business tax ID. 
Lead Business Owner Information

Max 40 characters

Max 80 characters

Max 80 characters
Email and Phone Contact Information






Business Information

Max 255 characters

Max 255 characters

If your business income is taxed on your personal income tax return, you should enter your name. (Max 80 characters)

Max 80 characters

Enter the street address where day to day operations take place - example: 1100 Wilson Street.
If the business is mobile - a food truck, fishing boat, ride share driver, etc, provide the address where the vehicle is stored during non-business hours.
(Max 255 characters)



Alternative Business Information


Max 255 characters



Additional Business Information

If you are selected as a finalist, you will be required to submit tax records that match the business structure you select on this question. If you are unable to supply such information, you may be ineligible for a grant award. Please select the above while considering these requirements.

Max 100 characters


Employment

For this section, full-time workers are those who work 35 hours/week or more;
part-time workers are those who work less than 35 hours/week.


Enter whole number - No decimals

Enter whole number - No decimals

Enter whole number - No decimals

Enter whole number - No decimals

Enter whole number - No decimals

Enter whole number - No decimals
Primary Industry










Numerals only



Socioeconomic Data

The next portion of the survey requests socioeconomic data related to the lead business owner and it is optional; if you wish not to provide socio-demographic information, please select 'Prefer not to say'. Please provide information based on how the lead business owner self-identifies.













Grant Information


Max 250 characters

For restauranteurs/food entrepreneurs with multiple locations, please respond based on your highest grossing location.

Max 250 characters



Max 1000 characters

Max 1000 characters
Conflict of Interest

You have selected Yes
Thank you for taking the time to submit your application to LISC Small Business Relief Grant Program. We will be unable to fund you in this round if you or your business have conflicts of interest with any of the corporations listed above. If you selected yes in error, please update your answer accordingly.  

You have selected Yes
Thank you for taking the time to submit your application to LISC Small Business Relief Grant Program. We will be unable to fund you in this round if you or your business have conflicts of interest with any of the corporations listed above. If you selected yes in error, please update your answer accordingly.  

You have selected Yes
Thank you for taking the time to submit your application to LISC Small Business Relief Grant Program. We will be unable to fund you in this round if you or your business have conflicts of interest with any of the corporations listed above. If you selected yes in error, please update your answer accordingly.  
Additional Information Required for Background Verification






Thank you for your interest in the LISC Small Business Grant Program. We will be unable to process any grant application to your business without agreement to the terms and conditions. 

Based on your answers, you have not accepted the terms and conditions. If you have entered your information incorrectly, please select 'Previous Page' and correct your responses.  

If you have questions or clarifications, please email us at SmallBusinessGrants@lisc.org and continue to monitor LISC's Small Business Resource page for updates on additional resources and programs.

Final Step: Please review the information below, e-sign and submit your application:

Thank you for completing your application. Please click 'Submit' below to complete your submission. 

If your business is selected as a finalist, you will be notified via email. Being selected as a finalist does not guarantee a grant will be awarded. As a finalist, additional documentation will be required, including date of birth, SSN, TIN/ITIN and/or EIN for the applicant and/or the business in order for us to perform the due diligence required by the program’s funding source. 

This due diligence inquiry may include business verification that we will conduct at our expense. If the due diligence step is successfully completed, we will ask for W-9 and appropriate banking information so that we may transfer funds by ACH to your designated account.

For general questions, please check the FAQ regularly for updates about the LISC Small Business Grant. For additional questions not answered by the FAQ, please email SmallBusinessGrants@lisc.org. We are monitoring this email regularly and updating our FAQ accordingly. 
 
For data security questions, please review LISC’s Privacy Policy. 

For updates on additional resources and programs, visit LISC's Small Business Resource page.