Grants Portal - Create an Account

INSTRUCTIONS:
This screen allows you to create a new portal account that you can use to log into the system. Please enter the following information. Any field with a * is a required field. Once you create your portal account, you will be notified when the review process is complete. Once your account is approved, you will be able to log in and apply for DOLA online grants that are available or manage an existing project.

Honorific:
First Name:*
Middle Name:
Last Name:*
Suffix:




Physical Address:*
Physical City:*
Physical State:*	Physical State
Physical Zip Code:*




Mailing Address:*
Address 2:
City:*
State:*	State
Zip Code:*




Phone Number:*
Alternate Number:*
Fax Number:
Email Address:*
Confirm Email Address:*
Please explain why you are requesting for the account to be created:*




Enter a Username:* You must enter a minimum of eight characters and a maximum of 30 characters. You can enter symbols, letters, and numbers. Usernames are not case sensitive.
Enter a Password:* You must enter a minimum of eight characters and a maximum of 16 characters. You can enter symbols, letters, and numbers. Passwords are case sensitive.
Please Confirm Your Password:*
Please confirm that you are not a robot:*

|CANCEL