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Grant Application
NYSTAR Innovation Asset Contact Email
*
NYS Innovation Asset Name
*
Applicant applying on behalf of the manufacturer identified below.
NYS Innovation Asset Contact Name
*
First
Last
Manufacturing Partner Contact Email
*
Manufacturing Partner Company (requesting the project)
*
Manufacturing Partner Contact Name
*
First
Last
Manufacturer Address
*
Street Address
City
Alabama
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Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
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South Carolina
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Tennessee
Texas
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West Virginia
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Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Manufacturer's D&B D-U-N-S Number
*
For more information: https://fuzehub.com/manufacturer-impact-prep/
Manufacturer's NAICS Code
*
Project Information
Project Title
*
Briefly describe the project and its costs, and how it addresses a COVID-19 related challenge
*
What is the NYSTAR Asset contribution to the project?
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Grant Amount Requested
*
Enter a number, no commas or decimals
Budget Information
What is the estimated total cost of the project?
*
For the project budget, use this file as a template:
Click Here to Download Project Budget Template
Upload a project budget
*
Accepted file types: xls, xlsx.
Please use the template from above to complete your project budget and demonstrate the cost sharing aspect: 1:5 Example: To receive the maximum award of $10,000, the manufacturer must show a total budget of at least $12,000 with the manufacturer’s contribution of at least $2,000.
Describe the economic impact this project will have within one year (including sales, cost savings, jobs created, other social benefit, etc.).
*
Explain how the goals are quantifiable, timely and achievable.
When is the estimated project completion date?
*
Projects must be completed within 12 months of signing grant award contract.
I certify the manufacturer has less than 500 employees in NYS and meets all eligibility requirements.
*
Yes
X