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* 1. First & Last Name 

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* 2. Business Name

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* 3. Email

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* 4. Phone Number

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* 5. Physical Address (Business)

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* 6. Mailing Address (If different than physical address)

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* 7. Property Owner Information

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* 8. Business Tax ID#

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* 9. EVENT SPACE ACTIVATION: 
Please provide a detailed description of the event you are planning.
If you are planning on Physical space activation, please respond N/A here.

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* 10. PHYSICAL SPACE ACTIVATION:
Please provide detailed description of your project.
If you are planning an event space activation, please respond N/A here. 

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* 11. Please name who the reimbursement check should be made payable to.

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