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2. 
4. City of Lowell Small Business Expansion Program Application
6. Please review the program guidelines before filling out this application.

   CDBG Small Business Expansion Program Guidelines

8. Applicant's Full Name*
9. Applicant's Home Address*
11. City*
12. State*
13. Zip Code*
15. Business Name *
16. Business address*
18. City*
19. State
20. Zip Code
22. Phone Number (daytime) *
23. Email Address*
25. Type of business: *
    -- Select One --Retail Restaurant/Food ServiceServices Small ManufacturingOther
26. Years in Business *
    -- Select One --Startup Less than 1 year 1-3 years 3-5 years5+ years
28. Type of Business Structure *

    1. Sole Proprietor (D/B/A)
    2. Partnership (GP, LP or LLP)
    3. C-Corporation
    4. S-Corporation
    5. LLC
    6. Nonprofit organization
29. Unique Entity ID (UEI) #

    *If you do not have a UEI # for your business, please request one. 

31. Total number of full-time employees, excluding business owner*
    -- Select One --01-55-1010 or more

    Full-time=40 hr. week

32. Total number of part-time employees, excluding business owner*
    -- Select One --01-55-1010 or more

    Part-time=less than 40 hrs. per week

34. Tax return*

    Please upload a copy of your more recent federal tax return.

35. Lease agreement*

    Please upload a copy of your lease agreement. Month-to-month leases are not accepted.

37. Please upload your project budget *

    Sample Budget

39. Upload letter of intent*

    Please demonstrate the need for funding to assist with your business expansion and job retention/creation. This description should align with your budget. Sample letter of intent.

41. Company's website
43. Have you previously participated in a Technical Assistance program offered by the City of Lowell or other Technical Assistance provider?*

    1. Yes
    2. No
45. If you answered "No", would you be interested in participating in upcoming Technical Assistance Program?*

    1. Yes
    2. No
47. Are you a U.S citizen?*

    1. Yes
    2. No
49. Have you ever been charged or convicted of any criminal offense other than a minor motor vehicle violation*

    1. Yes
    2. No
51. Are you part of a political party, a campaign, a public official, or a business entity formed by or for the benefit of any public official? *

    1. Yes
    2. No
53. Are you an employee of the City of Lowell?*

    1. Yes
    2. No
55. Declaration *

    1. True

    I certify that the information on this form is true and accurate to the best of my knowledge. I also understand that the demographic and income information I provided is subject to verification by the Federal Housing & Urban Development Department (HUD).
57. We will contact you shortly via email to let you know if you have been approved under the Small Business Expansion Program or if we need additional information.
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61. 1. Receive an email copy of this form.
62. Email address

    This field is not part of the form submission.

63. Submit Submit and Print

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