Growth Incentive Program Application

All fields must be completed in order for the business to be eligible for funding.

City of:(Required)

Email(Required)

Business Name(Required)

Full-time employees as of(Required)

(number of employees)(Required)

Number of new jobs created:(Required)

Customer's 2010 Population(Required)

Less than 500

Between 500 and 5,000

Greater than 5,000

Information required for each qualifying employee. AT LEAST ONE employee’s information is required for consideration.

Qualifying Employee(s)(Required)

Employee Name (First & Last)

Home Address

Wage

Dates of Employment

Number of resignations or terminations since last job creation incentive payment(Required)

Date(Required)

Number(Required)

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