Delta Covid Relief Grant Application

Delta County COVID Relief Grant Application

Thank you for your inquiry. Please complete the preliminary application below as your first step in applying for the Delta County COVID Relief Grant Program. We will contact you for further information.

Business Name (specify DBA)

Contact Name and Title

Mailing Address (PO Box/Street, City, State, Zip) *

Physical Address (if different than mailing address) *

Phone *

Website/URL

Type of Business (Mgf., Retail, etc.) *

Employer Identification NUmber (EIN) or Last Four Digits of SSN *

Number of Employees *

Please designate how many full-time and how many part-time

Did you receive federal CARES Act funds (PPP and/or EIDL)? *

Yes, PPP

Yes, EIDL/EIDL Advance

No, neither

What do you estimate your COVID-related losses to be? *

If unknown at this time, please enter "unknown"

Amount of grant request ($10,000 max): *

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Delta County COVID Relief Grant Application

145 S Cascade | Montrose, Colorado 81401 | Phone: (970) 249-2436 | Fax: (970) 249-2488 | info@region10.net