Catalyst Referral form
Information About You
Name
Address
Zip
Phone
City
State
E-mail
Jurisdiction:
Organization name:
Estimated project costs (if applicable or known):
Amount of funds already secured:
Have you ever received funds from DHCD?
No
Yes
If yes, when?
If yes, for what?
Information About What You Need
Nature of Request:
1. Do you want to start or expand a business?
2. Do you want to start a nonprofit?
No
Yes
3. Do you want help in developing a property?
No
Yes
4. Do you want help in developing a project?
No
Yes
Are you seeking:
1. Information/Referral?
No
Yes
2. Resources?
No
Yes
3. Technical assistance?
No
Yes
4. Other?
No
Yes
Explain:
No
Yes
Are you a:
1. Business?
No
Yes
2. Nonprofit?
No
Yes
3. Government agency?
No
Yes
4. An individual?
No
Yes
Do You Have a:
1. Business plan?
No
Yes
2. Community plan?
No
Yes
3. Strategic plan?
No
Yes