Registration

*Note: Once you have Created your Account for the Rock County COVID-19 Small Business and Non-Profit Grant Program, you will be able to start-and-stop / start-and-save your application. After you click the Registration button, the system might take a few seconds to activate. The red asterisks noted in the below registration form represent required data / information fields that must be filled-out before your Account will be activated. All fields marked with a red asterisk are required.

Display Name:

Enter a display name.

Email Address:

Enter a valid email address.

User Name:

Enter a user name. It must be of at least the minimum configured length, must be an alphanumeric value, must not start/end with a space, and must not contain any of these characters !"#$%&'()*+,/:;<=>?@[\]^`{|}

Password:

Enter your password.

Confirm Password:

Re-enter the password to confirm.

Security Code:

Enter the security code.

Enter the code shown above in the box below.