Technical Assistance Survey (CONFIDENTIAL)

Question Title

* 1. Contact Information

Name

Business

Business Address

City/Town

ZIP/Postal Code

Email Address

Phone Number

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* 2. Do you reside in Vancouver?

Yes

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* 3. Has your business been impacted by COVID-19?

Yes

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* 4. Please describe impact (e.g sales are down ___%)

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* 5. How long have you been in business?

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* 6. What type of technical assistance are you interested in?

Parklet & Sidewalk Café Assistance

Online Presence Development (Website, E-commerce, Social Media)

Shop Safely Marketing Campaign

n/a

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* 7. Demographic Information: Race (please check all that apply)

American

Asian

Black / African American

White

Hispanic

No Response

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* 8. Gender

Male

Female

Non-binary

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* 9. What is your annual household income? use slider or input in box (CONFIDENTIAL)

250,000

Clear

i We adjusted the number you entered based on the slider’s scale.

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* 10. Source of Income (for example: job, own business, social security, retirement, etc)

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* 11. What is your household size?

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* 12. Household Information

Special Needs Household?

Disabled Household?

Homeless?

n/a

Technical Assistance Survey (CONFIDENTIAL)

Question Title

* 1. Contact Information

Question Title

* 2. Do you reside in Vancouver?

Question Title

* 3. Has your business been impacted by COVID-19?

Question Title

* 4. Please describe impact (e.g sales are down ___%)

Question Title

* 5. How long have you been in business?

Question Title

* 6. What type of technical assistance are you interested in?

Question Title

* 7. Demographic Information: Race (please check all that apply)

Question Title

* 8. Gender

Question Title

* 9. What is your annual household income? use slider or input in box (CONFIDENTIAL)

Question Title

* 10. Source of Income (for example: job, own business, social security, retirement, etc)

Question Title

* 11. What is your household size?

Question Title

* 12. Household Information

Question Title

* 13. By typing my legal name, I certify that this information is complete and accurate.