OPPORTUNITY INVESTING

Diverse Erie 2026 Mini-Grant Application

Small Business Mini Grant 2026

Please fill out the application completely until you see the submit button. If you can’t complete all at once, you can revisit the application by clicking on the link in your email.

"*" indicates required fields

Comments

This field is for validation purposes and should be left unchanged.

Date Summitted*

MM slash DD slash YYYY

Name of Individual Completing The Application*

Applicant Email*

Address of Individual Completing The Application*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Full Legal Company Name*

Month & Year Established*

EIN:*

Business Structure: CORP., LLC, Partnership, Sole Proprietor*

Has your business been in operation on or before June 10, 2021?*

Yes

No

Business Address (if different from the applicant address)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Do you as the owner identify as BIPOC as defined in the grant guidelines?*

Yes

No

Please Identify Race (check all that apply)*

African American or Black

Asian or Asian American

Native Hawaiian or Other Pacific Islander

American Indian or Alaska Native

Hispanic/Latino

White

Other

Percentage of Ownership Breakdown*

Business Alias: Do you or your business conduct business/provide services under any other name(s)? If so, please provide the names.

Total Revenue (Past 12 months)*

Fiscal Year Begins*

MM slash DD slash YYYY

Fiscal Year Ends*

MM slash DD slash YYYY

Website and/or Social Media Account Names*

Business/Organization Phone*

President/CEO Name*

First Last

Title*

Email*

Phone*

Additional Point of Contact*

Please include someone else at your business/organization that we can reach out to if the owner is unavailable.

First Last

Title*

Email*

Phone

Brief Company Description*

Identify The Product or Service The Business/Organization Provides*

Geographic Area Served*

Number of Full-Time Staff*

Number of Part-Time Staff*

Project Budget*

Requested Amount*

List Any Certifications Your Business Has

STATEMENT OF NEED-( Describe why the grant funds are needed and if your business experienced a hardship due to Covid-19)*

Character Limit: 2000

PROPOSAL SUMMARY (Please include how you plan on utilizing the grant funds)*

Character Limit: 5000

COMPANY BACKGROUND (Provide a brief history of your company, include significant accomplishments or highlights)*

Character Limit: 5000

IMPACT (Please describe how your business/org or service responds to harm caused by COVID-19, and how the project impacts the BIPOC community)*

Character Limit: 5000

BUDGET OVERVIEW (Please provide a breakdown of products and/or services to be used and items to be purchased as part of this project)*

Character Limit: 5000

BUDGET DETALS

Upload and itemized budget with descriptions, justification, cost, quantities, and totals for your project.

Max. file size: 15 MB.

Are there any local, state or federal tax liens filed against the business/organization?*

If yes, please provide explanation in box below.

Yes

No

Is the business/organization current with all local, state, and federal taxes?*

If no, please provide explanation in box below.

Yes

No

If your business/organization answered 'yes' to being current with all local, state, and federal taxes, please attach last two years' federal tax returns.

Drop files here or

Max. file size: 1 GB.

Tax Lien Details (If you answered 'yes' to having a tax lien against your business or 'no' to be current with all federal, state, and local taxes, please provide explanation and details of payment agreements (if applicable) in the box below.

Character Limit: 5000

Further Tax Details (if needed)

Character Limit: 5000

Any Additional Supporting Documents (if needed)

Drop files here or

Max. file size: 5 MB.

Acknowledgement*

I understand that making a false statement on this form is a violation of law and could result in criminal prosecution, significant civil penalties, and a denial of the grants.

Time of Proposal Submission*

Hours

:

Minutes

AM/PM

Consent*

By clicking “submit” (on the date specified in your application per the previous question)I state that the facts set forth in the foregoing are true and correct to the best of his/ her knowledge, information and belief, subject to the penalties of 18 Pa.C.S. §4904 relating to unsworn falsification to authorities.

DiverseErie_on_black

Diverse Erie Headquarters

208 E Bayfront Parkway, Suite 104

Erie, PA 16507

814-602-3043

dmitchell@eriedeic.org