Get More Information.

Please provide us with more information about you and your business’ needs. All information provided will be kept confidential. The information is only for purposes of determining eligibility.

Name

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

(###)

###

####

What is your preferred method of communication?

Call

Text

What type of business?

Please provide a description of the goods or services provided

Message

Number of Employees

What is your management structure?

Amount of grant or loan needed:

If unknown, simply put unknown

Describe below previous attempts to obtain capital (money) to create or expand your business

What are your general business expenses (rent, supplies, insurance, payroll, advertising, etc...) Weekly or Monthly?

What income, if any, is the business generating weekly or monthly (before accounting for your expenses)?

Get More Information.

COLLABORATIVE LAW & JUSTICE CENTER

Additional Legal Resources