Back2Biz PPE Initiative Application
Please Complete the Following Questions. Thank You
Email *
Date of Application
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Name of Business
Business Address
Contact Name
Contact Telephone Number
Is Your Business Currently Open?
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If No, Do You Plan to Re-Open?
Clear selection
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
If You Plan to Re-Open, at What Capacity? Check All That Apply
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
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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?
Clear selection
Thank You. A member of our team will be in contact with you regarding your application.
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