The Carrot Project Inquiry Form

Contact Information

Welcome to The Carrot Project's Loan and Business Assistance Inquiry Form! This survey is composed of the following sections:

Contact Information
Business Information
Business Assistance Request
Loan Request
Demographics and Permission Agreements

For some sections, you will need to refer to your financial information (gross sales, expenses, employees, owner's draw, etc.), and last year household income, so please have that information handy. The survey can take 15 minutes or more, depending on your preparedness. You can complete it in one sitting, or, if you prefer, you can save your response and continue later. Just use the Save & Continue bar across the top of each page. Please email businessassistance@thecarrotproject.org with any questions.

Thank you!

1. Please fill out the following contact information:

First Name *This question is required.

Last Name *This question is required.

Business Name

Business Mailing Street Address

Business Mailing Address 2

Business City *This question is required.

Business State *This question is required.

Business Zip

County

Primary Email *This question is required. This question requires a valid email address.

Cell Phone

Office Phone

Enter any additional contact names, addresses, emails and phone numbers as needed.