Fifth Ward Small Business Crisis Survey

Question Title

* 1. How has your business been impacted by this COVID crisis? (Choose answer that best fits)

We have not been negatively impacted, revenues are stable.

Our revenue is reduced, but we are still operating.

We have been very hard hit, and are currently not operational.

Question Title

* 2. The support we could most use right now is.. (Check all that apply)

Loans/Grants - Help finding them or applying to them

Strategy - Help thinking about how we can adjust our business for the current crisis, or plan for the future

Technical - Help adjusting our business to new modes of operating, e.g. going online, transitioning to delivery, etc.

Marketing - Help connecting with the community and communicating about our business with customers

Mental Health - Support during this hard time, to talk things through with someone (whether professional counselor or business owner going through similar struggles), or other emotional support resources

Support for employees - Resources to help furloughed or laid off employees apply for unemployment, manage their money, access food benefits, emotional support, etc.

Other (please specify)

Question Title

* 3. What industry are you in? (Choose best fit)

Restaurant

Grocery store

Manufacturing

Financial Institution

Healthcare or Social Assistance

Real Estate Rental, Leasing, or Management

Religious institution

Car-related (e.g. selling cars, car maintenance)

Service - Other (e.g. beauty, hair)

Retail trade - Other

Agriculture, Forestry, Fishing, and Hunting

Mining

Utilies

Construction

Wholesale Trade

Information

Transportation (of goods) and Warehousing

Insurance

Government or Public Administration

Professional Services including private education

Arts, Entertainment, and Recreation

Other (please specify)

Question Title

* 4. How many Fifth Ward residents..

Did you employ before this COVID crisis?

Are currently employed at your business?

Question Title

* 5. How long have you been operating? (This info will help us seek grants for the community)

Less than 2 years

2 to 5 years

5 to 10 years

More than 10 years

Question Title

* 6. Please provide the following optional contact information:

Name

Company

Address

Address 2

ZIP/Postal Code

Email Address

Phone Number