Uptown Main Street Business Survey
Uptown Main Street is working with businesses to gather information about our commercial corridor and provide technical assistance to interested businesses. Please fill out the form below. All information will be kept confidential and will only be viewed by UMS leadership.
I. Business/Owner Information
Please fill out the following information about your business.
Legal Business Name
Your answer
Doing Business As
Your answer
Type of Establishment (please check one):
Names of Business Owners
Your answer
Name of Business Owner Completing Form
Your answer
Business Address & Contact Information
Please provide your business' full address and phone numbers.
Street Address:
Your answer
Business Phone Number:
Your answer
Mobile Number:
Your answer
Business Email:
Your answer
Personal Email (if applicable):
Your answer
My preferred method of communication is:
We've been in business for:
Organization Type:
II. Demographic Information
UMS collects demographic information to better understand and serve our business community. All information is kept confidential.
Please check all that apply:
Please check the following box that most closely aligns with your identity:
Preferred Pronouns:
My Primary Language Is:
My Primary Language Is:
Your answer
Check the following box if you would prefer a technical assistance provider that speaks your primary language.
III. Business Property & Personnel
Information on your staff and space helps us provide appropriate assistance for your business. All information is kept confidential.
Number of full time employees (30+ hours/week):
Your answer
Number of part-time employees (<30 hours/week):
Your answer
Square Footage of Your Business:
Your answer
Do you own or lease?
If you lease, when does your lease expire?
MM
/
DD
/
YYYY
Is your lease a:
Do you expect any changes that may affect your real estate needs?
If yes, please explain:
Your answer
IV. Marketing Information
As part of UMS' mission, we're working to promote businesses along our corridor. We will promote your business through our social media channels, website, and communications.
Do you have a website?
What is your website's URL?
Your answer
Does your business use any of the following social media websites?
How often do you use social media to promote your business?
In what other ways to you promote your business?
If other, please specify:
Your answer
Does your business have accounts with any of the following websites?
What are the most significant challenges facing your business?
Your answer
What specific issues would you like to see addressed by Uptown Main Street?
Your answer
In rough approximation, how do your customers travel to your business?: ___% walk, ___% drive, ___% bus, ___% Metro.
Your answer
In recent years, has your customer traffic increased, decreased, or remained the same?
Your answer
What, do you think, has led to this change in customer traffic?
Your answer
V. Assistance Inquiry
Uptown Main Street has funds to provide businesses with technical assistance and storefront improvements. To learn more about these offerings, please select from the options below.
Please check all services you are interested in receiving:
Are you interested in being added to our newsletter list?
Are you interested in volunteering?
VI. Statement of Understanding
By submitting this information, I am requesting technical assistance services from Uptown Main Street. I agree to provide all information requested by Uptown Main Street staff, volunteers and/or consultants in connection with these services. I agree to provide any requested data on accomplishments, the status of work and metrics on the impact of this assistance. I understand that all information will be kept confidential. In consideration of the consultants furnishing this technical assistance, I waive all claims again Uptown Main Street that may arise from this assistance.

I understand that any information disclosed will be held in strict confidence. UMS will not provide your personal information to commercial or government entities.

Please sign your name, acknowledging that you agree to the statements above *
Your answer
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