Funding Application

Applications will be received on a Rolling Basis.

Additional information may be requested if you submitted your application prior to November 13, 2012.

Name of Person Completing Application *
Name of Person Completing Application
Personal Phone Number *
Personal Phone Number
Mailing Address *
Mailing Address
Business Address *
Business Address
Business Phone Number *
Business Phone Number
(at this location)
(ie, Gift Store, Restaurant, Salon, Convenience Store, Laundromat, etc.)
Was your business open to the public immediately prior to Hurricane Sandy (October 29, 2012)? *
(Pre Storm)
Prior to Hurricane Sandy, were your annual revenues in excess of $2 million? *
Have you had to close your business as a result of the storm? *
If you have re-opened, have you been able to resume pre-storm business hours and services? *
How do you intend to use the Restore Red Hook emergency grant of up to $5,000? Check one or more categories below, describe the loss/damage/need, and specify how you will use the grant funds, including amount needed for each item.
Please check and fill out the below descriptions for selected items *
Did you have flood insurance at the time of Hurricane Sandy? *
Have you applied for FEMA or any other governmental assistance to cover the costs of repair or replacement of damage or loss incurred as a result of the hurricane? *
I hereby certify that the above information is true and correct, and that I have the authority to apply for the Restore Red Hook emergency grant on behalf of the above-named business. I further certify that any grant received shall be used only for the business making this application, and for the purpose stated in this application. I further certify that I do not expect that any insurance reimbursement or or any governmental assistance will cover the cost of the specific item(s) for which I am seeking an emergency grant. *