Small Business Administration Grant Application

R3 has received funding through the Small Business Administration to provide technical assistance and financial assistance to small businesses located in Burns and Baker City, Oregon. We anticipate making awards ranging from $1,000 up to $50,000 depending on the business size, need, and funding impact. Awards will be made on an ongoing basis until all funds are expended. Please complete this brief survey to apply.

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* 1. Business Name:

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* 2. Business Street Address:

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* 3. Years in Business:

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* 4. Please enter the amount of funding you request for your small business/enterprise.

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* 5. Please describe the purpose and anticipated use of this funding:

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* 6. Please describe the anticipated impact for your business if this funding is awarded:

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* 7. How many new jobs will be created if this funding is awarded? (the answer may be zero):

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* 8. How many existing jobs will be retained or saved if this funding is awarded? (the answer may be zero):

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* 9. How much additional investment or increased sales/profitability will result from this funding award? (the answer may be zero):

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* 10. What new products or services will be provided as a result of this funding award? (the answer may be none)

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* 11. Are any other community benefits anticipated due to this award?

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* 12. Please enter your first and last name:

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* 13. Please enter your job title or role as it relates to this business:

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* 14. At what phone number would you like to be contacted?

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* 15. At what email address would you like to be contacted?

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