Sync South Bend Security Grant Application
The Business Security Program gives grant money and resources to local businesses in South Bend for security enhancements.
Would you like to apply for Core reimbursement or a full security assessment grant?
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Grant Application
Fusus Core Reimbursement
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Screening Question
Is this business or Non-profit located within South Bend City limits?
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Yes
No
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Thank you for your interest; however, the organization must be located within South Bend city limits to be eligible.
Thanks, anyway!
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Business / Organization Information
Please share details about the organization applying to receive the grant or reimbursement.
Organization Name
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Please ensure this name matches the name that appears on your W9 form and your business license / 1023 tax form.
Owner Name
First Name
Last Name
Owner Email
*
example@example.com
Owner Phone Number
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Please enter a valid phone number.
Format: (000) 000-0000.
Business Address (must be within South Bend city limits)
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Street Address
Street Address Line 2
City
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Is your organization part of or a subsidiary of another company?
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Yes
No
If yes, please provide the name of the parent company:
Please attach a copy of your business license or your 1023/1023-EZ form
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Browse Files
Drag and drop files here
Choose a file
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Please attach a copy of your receipt(s) from the Fusus Core purchase
*
Browse Files
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of
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Is the organization owner the best contact person for the application process?
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Yes
No
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Application Contact Information
Please share the primary contact information for the best person to contact during the grant process.
Primary Contact Name
*
First Name
Last Name
Role / Job Title with Organization
*
Email
*
example@example.com
Primary Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Alternate Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
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Business / Organization Information Continued
Which of these categories best describes your organization?
*
Please Select
Apartment Complex
Business run out of home office
Business with multiple locations
Charity, tax-exempt, or non-profit
Manufacturing or industrial
Local Restaurant
Local Service
Property Management
Is this organization registered as a 501(c)(3) or other 501(c) status?
Yes
No
Please select your organization's 501(c) status:
501(c)3
Other
What kind of services or goods does your organization provide?
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How many years has your organization been in business?
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How many employees does your organization have?
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Is your organization a Disadvantaged, Minority, or Women Owned Business Enterprise? If so, select all that apply:
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Disadvantaged Business Enterprise (DBE)
Minority Business Enterprise (MBE)
Women Owned Business Enterprise (WBE)
This does not apply to my organization
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Grant Structure Information and Consent
I acknowledge and accept that installation of a fususCORE and connection to the City of South Bend's Real Time Crime Center is a requirement for participation in this Grant Program.
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Yes, I understand my camera(s) will be conntected
No, I do not want my camera(s) connected
NOTE: Your organization can choose which and how many cameras are integrated with the Real Time Crime Center. For more information, please visit syncsouthbend.org
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Thank you for your interest; however, to participate in this process your security system must be connected to the South Bend Police Department's Real Time Crime Center.
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Thanks, anyway!
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Please Briefly Share Your Security Needs
Consider your main security concerns when describing your needs. Note: if your organization is selected our Security Vendor Partner will be working with you to conduct a site visit, provide a quote, and perform installation.
Share below:
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Please share with us your reimbursement needs
Note: A site visit to confirm purchase and/or installation of a fususCORE will be required prior to reimbursement approval.
fususCORE Type
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Number of cameras connected
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Cost ($)
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Is your fususCORE already installed on your premises or will it need to be installed?
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Yes, already installed
No, needs to be installed
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Terms and Conditions of the Application
Signature
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Math Security Challenge
Submit
Should be Empty: