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Page 1 of 2 <br /> <br /> <br /> <br />KITTITAS COUNTY STRONG SMALL BUSINESS GRANT <br />Cares Act Funding – Kittitas County <br />The information provided allows the Kittitas County Chamber of Commerce to evaluate your grant application. <br /> <br /> <br />Company Name: <br />Location: <br />Year of Establishment: In Operation for <br />at Least 1 Year? <br /> Yes No <br />UBI Number: <br />CEO/President <br /> Name: <br />Email: <br />Phone: <br /> Industry <br />Sector: Retail Restaurant/Food Business Hotel/Airbnb Gym/Fitness Facilities Movie Theater Museum Other: _ <br /> Business <br /> Type: OMWBE certified Veteran Women owned Minority Owned Other: <br /> Race and <br /> Ethnicity: White Hispanic or Latino Black or African American American Indian or Alaskan Native Asian Native Hawaiian or Pacific Islander <br /> Other:________________________________________ <br /> Has your business been affected by emergency public health protections <br />in place and/or mandatory closure by executive order due to COVID-19? Yes No <br /> <br />Amount of Emergency Grant Money Being <br />Requested: $______________________ Request cannot be more than $5,000. <br />COMPANY BACKGROUND <br />Total Number of <br />Employees as of <br />03/2020: <br /> <br /> <br /> <br />Number of Workers Laid Off Due to COVID-19: <br />If one employee only, is this a sole proprietor? Yes No <br />Company Description: <br />Describe the company and its products/services. <br />Economic Impact: <br />Describe the effect of the public health crisis on the business and how allocated funds can help the business. Why funding is critical to this business? <br /> <br /> <br /> <br /> <br /> <br />Submitted By: <br />Business Name: <br /> <br />Contact Name: <br />Title: <br />Phone: Direct <br />Mobile <br />Email: