Project Green Light Application

Project Green Light Application

*Mandatory DocuSign link occurs when form is submitted, you MUST complete that step as well*

Detroit Business Address*

Business Name*

Business Corporate Entity Name*

Business License Number

Business License Expiration Date

Business Phone Number*

Name of Corridor (if applicable)

Owner's First Name*

Owner's Last Name*

Owner's Date of Birth*

Owner's Home Address*

Owner's Phone Number*

Owner's Email*

Primary Contact (if not owner)

Primary Contact Phone

Primary Contact Email

Select Business Type*

Gas station

Grocery Store

Liquor Store

Restaurant

Medical

Apartment Building

Apartment Complex

Church

Community Center

School / Vocational Center

Child Care Center

Car Wash

Bank

Detroit Housing Commission

Laundromat

Retail Store

Entertainment facility

Multi-Use Complex

Other

Non-Profit

Marijuana Grow Op

Marijuana Dispensary

Storage Facility

List Business Days and Hours of Operation*

Are you the business owner?*

Yes

No

Do you own the building?*

Yes

No

How many businesses occupy your building?*

How many businesses would you like to enroll*

Number of public entrances*

How is the property used?*

Retail

Residential

Industrial

Offices

Multi-use

Hotel / Motel

Select Property Description*

Single business in one building

Single business in two or more buildings

Multiple businesses in one building

Multiple businesses in two or more buildings

Multiple residences in one building

Multiple residences in two or more buildings

Select a camera installer*

Access Surveillance

Accurate Networks

Comcast

Cronus

Guardian Alarm

IC Datacom

Identify Inc

Infinite Technologies

IView

Security Countermeasures

Securatech

Select a sign vendor*

Dearborn Signs

ID Enterprises

Select a light vendor*

IB Electric

Do you agree to the sign the MOU?*

I Agree

How did you hear about Project Green Light?

Select or enter value

Let us know why you are interested in joining

Send me a copy of my responses

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