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* 1. What kind of business do you operate?

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* 2. How long has your business been in operations?

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* 3. Do you own or lease your business space?

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* 4. How many people does your business employee?

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* 5. Does your business have an online sales component? 

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* 6. If your business has an online sales component, approximately what portion of your overall revenue comes from online sales?

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* 7. Has your business resumed storefront operations under the Governor's guidelines due to the the COVID-19 public health emergency?

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* 8. How many of your employees did you have to lay off as a result of the coronavirus?

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* 9. How has COVID-19 affected your business? (Please check all that apply)

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* 10. How has your business revenue changed since COVID-19 became a widespread concern in early March 2020?

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* 11. If business disruption continues at the current rate, how soon will your business be at risk of closing permanently?

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* 12. At this time, what are you most concerned about? (Please choose all that apply)

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* 13. Did you receive any financial assistance due to the COVID-19 pandemic? (Please check all that apply)

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* 14. What is the name of your business? (Optional)

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* 15. What is your email address? (Optional)

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* 16. Has your business participated in the Bucks' Bucks program where the customer has their money doubled by a private fundraising effort?

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* 17. Is there anything else you would like us to know? 

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