50/50 Small Business Start Up Grant

Application

Applicants Name ________________________________________________________

Address ________________________________________________________________

Phone __________________________________________________________________

Email __________________________________________________________________

1. Give a brief description of the business you will be opening in the City of Augusta:

2. Give a brief description of what the grant money will be used for:

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3. Do you feel that this grant will be a determining factor to starting your business? Please explain.

Grant Amount Requested __________________________

Your Matching Share   _____________________________

Total _____________________

Signature _____________________________________    Date ___________________

Please return completed copy to Augusta City Hall

Augusta City Hall

P.O. Box 502

Augusta, AR 72006

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