Illinois Social Equity Criteria Questions

In order to apply for a dispensary license, an applicant must prove that 51% or more of the applying entity is owned by one or more individuals who each meet the combination of at least one of the criteria under Criteria A and Criteria B. The below information, will allow us to confirm your qualification.

First name*

Last name*

Email*

Phone number*

Criteria A

In order to qualify under Criteria A, an individual must have resided for at least 5 of the 10 preceding years in a neighborhood that has a high poverty rate, a high percentage of households that receive SNAP, low income/low access to supermarkets, or a high percentage of residents failing to graduate from high school.

Address

Please list all addresses where you have resided for the last ten years
If you are not comfortable providing this information via this form, call us at 602-290-9424.

-OR-

For at least 5 of the preceding 10 years, have you received:*

- Medicaid
- Supplemental Security Income
- Social Security Disability
- Subsidized Housing

Criteria B

In order to qualify under Criteria B, an individual must answer yes to one of the below conditions.

Have you or a family member been arrested for, convicted of, or adjudicated delinquent for any offense, or substantially similar offense, of Illinois, Federal, or other state law for:*

- possession of 500 grams of cannabis or less; or
- manufacture, delivery, or possession with intent to deliver, or manufacture or cannabis up to 30 grams

Yes

Prefer Not to Answer

-OR-

Firearm Injury

Have you been a victim of firearm injury, evidenced by either a police report or medical record?

Yes

Prefer not to Answer