North Carolina General Assembly is about to go into session to consider COVID-19 relief measures, and they need to hear from you about what you need now and what obstacles you've faced as this crisis has evolved. Your responses will allow us to advocate with our elected officials on your behalf to help get the relief and support businesses in our community need. And, your responses will help us create helpful programming such as workshops and town halls.

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* 1. Company Name

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* 2. Website

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* 3. Please select the industry category that best describes your organization.

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* 4. How has your business responded to COVID-19? Check all that apply

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* 5. What business resources do you need? (check all that apply)

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* 6. If your business has closed due to COVID-19, do you plan to reopen?

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* 7. If your business has closed or changed operations, what challenges do you foresee with reopening or resuming normal operations? Check all that apply.

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* 8. If your business reopens, do you foresee average wages this year:

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* 9. If stay-at-home guidelines were relaxed on the recommendation of public health and public safety experts by the dates below, your business would most likely operate how?

*Note: This question does not reflect a tentative timeline for changes in directives at any level of government, but helps us understand the impact of business disruption

  Continue Partial Operations Resume Normal Operations Close
By May 15, 2020
By June 1, 2020
By June 15, 2020
By July 1, 2020 or beyond

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* 10. What resources would your business need to reopen?

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* 11. What business continuity concerns do you have?

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* 12. Have you heard of the U.S. Small Business Association's Paycheck Protection Program (PPP)?

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* 13. Have you applied for a loan through the U.S. Small Business Association’s Paycheck Protection Program (PPP)?

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* 14. If you applied for a PPP loan, please answer the following:

  Yes No
Was your application for a PPP loan approved?
Did your loan match the amount you requested?
Do you have concerns about the duration of the program?
Do you anticipate being able to have your PPP funds forgiven?
Have you received your PPP funds?

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* 15. If you did not apply for PPP, do you intend to apply if PPP funding is replenished?

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* 16. What were the barriers you experienced to PPP? Select all that apply

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* 17. Have you heard of the U.S. Small Business Association’s Economic Injury Disaster Loan program (EIDL)?

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* 18. Have you applied for a loan through the U.S. Small Business Administration’s Economic Injury Disaster Loan program (EIDL)?

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* 19. If you applied for EIDL, please answer the following:

  yes no
Was your application for EIDL approved?
Did your loan match the amount you requested?
Have you received your EIDL funds? 

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* 20. If you did NOT apply for EIDL, do you plan to apply for EIDL if funding for the program is replenished?

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* 21. What were the barriers to your EIDL application? Select all that apply.

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* 22. Have you applied for other COVID-19-related relief? Check all that apply.

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* 23. Additional comments/concerns

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* 24. Contact Information

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* 25. What is your position at your organization?

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* 26. How many employees were part of your organization before the onset of COVID-19-related disruption?

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* 27. Select the counties/areas in which your business operates:

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* 28. Is your business certified as a Historically Underutilized Business?

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* 29. Is your business veteran-owned?

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* 30. Are you of Hispanic or Latinx origin?

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* 31. How would you describe your race?

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* 32. Do you identify as a member of the LGBTQ community?

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* 33. Select your age range

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* 34. How would you describe your gender identity?

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