Facade Grant Program - Preliminary Application Form

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After you submit this form, you will be contacted by a member of the review committee, who will review the information with you. Please submit all supporting documentation via email to perkasiefacadegrants@gmail.com.

Successful applicants are eligible for 50 percent reimbursement, to to a maximum of $5,000. Grants DO NOT have to be repaid.

Applicant Name *

Building Owner or Tenant *

Building Owner

Tenant

Required

Business Name *

Business Address *

Phone Number *

Address of Facade to Be Improved (if different from above)

Contractor Name and License Number *

Please Describe Planned Improvements *

Estimated Cost of Work *

Grant Request Amount

Anticipated Start Date *

YYYY

Anticipated Completion Date

YYYY

Submit

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