Lewis County Business Survey

Department of Emergency Management Lewis County Small Business Survey

The purpose of this survey is to track the affect COVID-19 is having on our local Lewis County Businesses. This information will be used to inform business relief program applications and public policies it is also important to note that State and Federal agencies are starting to roll out programs as such as low interest loans from the SBA.

Question Title

* 1. The Name of your Business

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* 2. Please enter your business information a 24 hour contact

Name

Company

Address

Address 2

City/Town

ZIP/Postal Code

Email Address

Phone Number

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* 3. Type of Business

Food

Retail

Service

Other (please specify)

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* 4. Date of limited hours or Services (If Applicable) Please specify

Date / Time

Date

Time

AM/PM

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* 5. Date of Closure (If Applicable)

Date / Time

Date

Time

AM/PM

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* 6. Number of Employees

Number of employees out of work

Number of employees who are working from home

Number of essential employees still working

Lewis County Business Survey

Department of Emergency Management Lewis County Small Business Survey

Question Title

* 1. The Name of your Business

Question Title

* 2. Please enter your business information a 24 hour contact

Question Title

* 3. Type of Business

Question Title

* 4. Date of limited hours or Services (If Applicable) Please specify

Question Title

* 5. Date of Closure (If Applicable)

Question Title

* 6. Number of Employees

Question Title

* 7. Any additional comments