Please complete this survey regarding your ability to purchase cleaning supplies, food, or other materials for your center.

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* 1. Name of Provider

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* 2. Name of person completing the survey

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* 3. What supplies/materials are you having difficulty obtaining?

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* 4. What barriers have you come across while attempting to purchase supplies/materials that are available?

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* 5. If you could obtain enough supplies/materials to serve the children who are currently enrolled in your center, would you remain open or reopen?

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* 6. If you answered "No" to question 5, please tell us why?

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* 7. What other information would you like to share with the coalition regarding supplies/materials for your business?

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