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* 1. Has your business been closed or drastically reduced hours due to COVID-19?

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* 2. How many employees are currently laid off or furloughed due to this closure?

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* 3. Would your staff benefit from canned foods, thermometers, hand sanitizer and other household goods?

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* 4. If we can deliver "shelter in place" supply kits, can we deliver them to your business and count on you to let your employees know these kits are available to them?

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* 5. Please fill in your contact information if you would like us to follow up with you.

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