Black Restaurant Fund Growth Capital Intake Form

Think your business is a good fit for the Black Restaurant Fund? If your business is eligible someone from LISC will be in touch to schedule an introductory phone call with you within the next two weeks.


This form captures preliminary information for a business seeking a Growth Capital Investment. Before proceeding, LISC recommends that respondents read the online FAQ for more information.

Terms and Conditions

LISC is collecting the information in this questionnaire to determine if and how our programs can be of assistance to you. For business owners with multiple businesses, please answer this questionnaire for one business only.  Before proceeding, LISC recommends that respondents read the FAQ associated with the program you are interested in for more information. Please email SIGrowthCapital@lisc.org for questions and troubleshooting.


Eligibility is based on accurate and complete submission of this questionnaire. Current directors, officers, employees and contractors of LISC or other donor companies and such individuals' family members (spouse, parents, children, grandchildren, great-grandchildren, and spouses of children, grandchildren, and great-grandchildren) may not be eligible to participate in the program.


Privacy: Information provided through this intake process is the responsibility of each business owner and remains confidential. Applicants will not hold LISC or LISC’s 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 Form Assembly. More info.

You will see a confirmation page after successful completion of this form.
Initial Questions

Business Owner 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. 
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

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


Max 100 characters




Total Number of Workers 

The following questions ask about the number of employees at all locations operated by the applicant.
  
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
Socioeconomic Data

LISC is a nonprofit organization that is generally exempt from taxation under Section 501(c)(3) of the Internal Revenue Code and was formed to further charitable purposes. The below questions seek to determine how your business’ participation in this program furthers LISC’s charitable mission. Providing demographic information is optional, and you are under no obligation whatsoever to provide such information.  Your responses will help us be responsive to government and private funders, who are increasingly asking for this information and promote our own accountability to LISC’s goals and mission where we aim to scale proven solutions, seed new ideas for closing racial health, wealth, and opportunity gaps and build the capacity of our partner organizations to do so. If you are comfortable, please respond to the questions below.

 

 

The next portion of the survey requests socio-economic data. Please provide information based on how you self-identify.









The Growth Capital Program seeks to provide access to flexible, growth-oriented capital to entrepreneurs. These investment dollars are not intended to be used as working capital and are not a replacement for debt financing. Instead, these investments are intended to fully fund a well thought out business expansion/growth plan. Investee businesses will repay LISC if/when their expansion plan succeeds. Please see a full description of the investment terms and structure here.  LISC has many other loan and grant programs. Only submit an inquiry for this program if this specific investment type works for your business.

Investment Information









Thank you for your interest in the LISC Black Restaurant Fund. We will be unable to process any application to your business without agreement to the terms and conditions or if you do not meet the eligibility criteria.  

Based on your answers, you have not accepted the terms and conditions and/or are not eligible for this program. 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 SIGrowthCapital@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 intake form. 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 an investment 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 our website for updates about the LISC Black Restaurant Fund. For additional questions not answered by the FAQ, please email SIGrowthCapital@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 Strategic Investments Website.