Permission to share responses with local organizations that offer resources to help businesses, organizations and individuals during and after COVID-19 *
First and Last Name *
Your answer
Business/Organization Name *
Your answer
Industry Category *
Business classification *
Current work status (due to COVID-19) *
Work place/location *
Workspace status *
Is your business facing a possible closure over the next 90 days? *
How many employees does your company have
Clear selection
Identify your key areas of concern resulting from impacts of COVID-19?(select all that apply)
What types of assistance would be most helpful to your business? (select all that apply)
Does your business have an online sales component? (select all that apply) *
Required
Would you be interested in offering a special promotion or partnering with similar businesses on a campaign during COVID-19 to continue operating? *
If you could put an estimated dollar amount on your COVID-19 expenses & losses- how much finacial support would bring you back up to where you were pre COVID-19? $______.___ *
Your answer
What support have you already applied for? (PPP, SBA, EIDL, EDD, etc.) *
Your answer
Are you working directly with a bank or applying for disaster relief loans on your own? If you are applying for loans on your own, what assistance do you need? *
Your answer
Are you currently involved as a member or volunteer of any of the following business organizations? (select all that apply) *