Illinois Department of Commerce and Economic Opportunity Grant Application Cover Page Job-Driven (JD) NEG Project Section 1: Applicant Information 1.1 Legal Name of Applicant: (Attach copy of W-9) 1.2 Address of Applicant: (Include your extended 9-digit zip code): 1.3 Officer: Name: (If more than one, attach a list with all Officers) Address: Fax: E-Mail: 1.4 Description of Applicant: (200 Character maximum) 1.5 NAICS Code: (6-digit Industry Classification Code) 1.6 Applicant Website: 1.7 Applicant FEIN: 1.8 N/A Applicant SSN: (Enter only if applicant is individual and does not have a FEIN) 1.9 Applicant’s DUNS Number: 1.10 Applicant Fiscal Year: From: To: 1.11 If applicable, indicate the following. Female-Owned Minority-Owned If minority-owned, then check Black / African Americans the appropriate race/ethnic Hispanic Americans group box. Native Americans Asian-Pacific Americans Asian-Indian Americans 1.12 Indicate the number of people expected to be served by the in the appropriate race/ethnic group box below. Race/Ethnic Group # People Served by Black / African Americans Hispanic Americans Native Americans Asian-Pacific Americans Asian-Indian Americans PARTICIPANTS:
Illinois Department of Commerce and Economic Opportunity Grant Application Cover Page Job-Driven (JD) NEG Project Section 1: Applicant Information 1.1 Legal Name of Applicant: (Attach copy of W-9) 1.2 Address of Applicant: (Include your extended 9-digit zip code): 1.3 Officer: (If more than one, attach a list with all Officers) Name: Address: Fax: E-Mail: 1.4 Description of Applicant: (200 Character maximum) 1.5 NAICS Code: (6-digit Industry Classification Code) 1.6 Applicant Website: 1.7 Applicant FEIN: 1.8 Applicant SSN: (Enter only if applicant is individual and does not have a FEIN) N/A 1.9 Applicant’s DUNS Number: 1.10 Applicant Fiscal Year: From: To: 1.11 If applicable, indicate the following. Female-Owned Minority-Owned If minority-owned, then check the appropriate race/ethnic group box. Black / African Americans Hispanic Americans Native Americans Asian-Pacific Americans Asian-Indian Americans 1.12 Indicate the number of people expected to be served by the in the appropriate race/ethnic group box below. Race/Ethnic Group # People Served by Black / African Americans Hispanic Americans Native Americans Asian-Pacific Americans Asian-Indian Americans PARTICIPANTS:
Job-Driven%20NEG%20Grant%20Application.docx