Business Owner / Service Provider Form
If you are a business owner or a service provider, please fill this form, with the information of the services you are providing. Please describe any special services / offers you have during this situation (COVID-19 Impact).
The intent of this form will be to connect the community to your business / service in whatever capacity we can. Submitting a request does not guarantee a response or service. We will do our best to help your request in getting fulfilled.
I certify that we are operating by the CDC's Interim Guidance for Businesses and Employers:
Business / Provider Name
Contact Phone Number
Contact Email Address
Business / Service Provider Category
Cab / Taxi Services
Child Care – In Home Care – Other Care
Handyman / Electrician / Plumber / Other services
Health and Wellness Coaching
Hotel / Motel / Other Accommodation Provider
Restaurant / Catering / Packed Food / Meal Provider
Tax Consulting Services
Urgent Care / Medical Services / Medical Supplies
Describe the services you provide:
Describe any specials you are providing during this time:
Describe if you need any help providing your services:
Describe any specific FREE services you may be providing (if any):
Please provide a link to any flyers you have have:
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