Boost Nassau Resource Center

Note: fields marked with a red asterisk (*) are required.

Your Information

First Name: *

Last Name: *

Email Address: *

Phone Number: *

Preferred Contact Method: *

Preferred Contact Time: *

Will you need assistance in a language other than English? *

If Yes, Please select the language: *

Applicant Information

Please describe your situation? *

Business or Organization Name: *

Address 1: *

Address 2:

City: *

State: *

Zip Code: *

Business or Organization Website Address:

Business Organization Type: *

Date of Business Formation: *

How many employees does your business or organization have? *

What industry are you in? *

Is your business or organization registered as a vendor with Nassau County? * Click here to register as a Vendor

Are you a certified Minority or Woman Owned Business? *

Are you interested in learning about certification?

Are you a Veteran? *

What type of assistance are you seeking? *

Loan

Grant

Residential Rent Relief

Commercial Rent Relief

Other

Is there a specific program you have questions about? *

If Yes, Please enter program name here: *

Please enter any questions or comments here: