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Lowell Entrepreneurship Assistance Program (LEAP)- Application

  1. Lowell makes

  2. New Vestures

  3. Difference makers

  4. capital-network

  5. City of Lowell Entreperneurship Assistance Program (LEAP)- Application Form

  6. What is your racial/ ethnic background

  7. Size of your Household

    Number of immediate family members living in household.

  8. Total annual gross income by all immediate family members living in household.

  9. Type of Business Structure *

  10. *If you do not have a DUNS # for your business, please request one. A D-U-N-S number is free to obtain. For more information visit: http://www.dnb.com/duns-number.html

  11. Do you owe property taxes, utilities, or other past due bills to the City of Lowell? *

  12. Have you ever been charged or convicted of any criminal offence other than a minor motor vehicle violation? *

  13. Are you part of a political party, a campaign, a public official, or a business entity formed by or for the benefit of any public official? *

  14. Are you an employee of the City of Lowell? *

  15. Declaration *

    I certify that the information on this form is true and accurate to the best of my knowledge. I also understand that the demographic and income information I provided is subject to verification by the Federal Housing & Urban Development Department (HUD).

  16. We'll contact you within five (5) business days to let you know if you have been selected to participate in the LEAP. If you have any questions, please contact: Maria Dickinson, Economic Developmnent Officer at (978) 674-1435 or via email at: mdickinson@lowellma.gov

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  18. This field is not part of the form submission.