Back2Biz PPE Initiative Application
Please Complete the Following Questions. Thank You
Date of Application
Name of Business
Contact Telephone Number
Is Your Business Currently Open?
If No, Do You Plan to Re-Open?
If Yes, When
If Open or Plan to Re-Open, How Many Full-Time Employees Do You Have?
What is Your Type of Business? i.e. Retail, Service, Restaurant, Not-for-Profit?
How Did You Hear About This Program?
If Open, What Capacity Are You Currently Operating At?-Check All That Apply
We Are Operating at Full Capacity
We Are Operating at Partial Capacity
We Have Hired All of Our Staff Back
Some of Our Staff are Still Furloughed
We Have Reduced Our Hours of Operation
If You Plan to Re-Open, at What Capacity? Check All That Apply
We Will Re-Open at Full Capacity
We ill Re-Open at Partial Capacity
We Will Hire All of Our Staff Back
We Will Hire Some of Our Staff Back
We Will Open at Reduced Hours
Does Your Business Need Sanitization and Personal Protection Gear to Open or Remain Open? If So, Please Check Which Products You Need
Are There Other Items That You Need to Re-Open or Remain Operational? If So, Please List
Can We Help You Earn You Consumer Confidence Recognition From Pottawattamie Public Health Department by Scheduling Your Personal Business Assessment
Does Your Business Need FREE Assisstance With Business Model Pivots, Financial Organization, Marketing, E-Commerce, Social Media or Content Creation? If So, Can We Assist by Scheduling an Appointment With Our Small Business Development Center?
Thank You. A member of our team will be in contact with you regarding your application.
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