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2. Business Name
4. Business Address
6. City
7. State
8. Zip Code
10. Contact Person First Name
11. Contact Person Last Name
13. Title
15. Phone Number
17. Email Address
19. Westminster Business License Number
21. Number of Employees
23. Building Ownership

    1. Own
    2. Rent
25. Description of Project
27. How will this project benefit the sustainability of your business?
29. What environmental value and benefit does this project hold?
31. How will this project positively impact your employees, customers, and/or the community?
33. Total Estimated or Actual Project Cost
35. Project Budget Attachment
37. Grant Amount Requested ($5,000 Maximum)
39. Estimated or Actual Project Completion Date
    Estimated or Actual Project Completion Date
41. Electronic Signature*

    I attest that the information stated above is correct and that the project is complete and in compliance with all City codes and regulations.

    1. Agree
43. Full Name (Including middle initial if applicable)*
44. Email Address*
46. Address*
48. City*
Leave This Blank:


50. 1. Receive an email copy of this form.
51. Email address

    This field is not part of the form submission.

52. Submit

* indicates a required field