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* 1. What industry does your business belong to?  Select the best fit for your business.

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* 2. Please describe the main activity your business performs below:

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* 3. In which town is your business located?

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* 4. How long has your business been operating?

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* 5. How has your business responded to the impacts of the Covid-19 pandemic?

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* 6. What has been the impact on your business turnover in the following months?

Please enter a percentage identifying the impact on business turnover based on your best estimates for each month below. For example if business turnover has decreased by 10% please enter -10%.

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* 7. Prior to the Covid-19 pandemic, how were you expecting your business income to trend for the 2019/20 financial year?

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* 8. How many staff members has your business stood down temporarily (total jobs not FTE)?

Please enter a numerical value for each employment type. If not applicable, please enter 0 for each employment type.

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* 9. How many staff members has your business let go of permanently (total jobs not FTE)? 
Please enter a numerical value for each employment type. If not applicable, please enter 0 for each employment type.

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* 10. What impact do you predict the Covid-19 pandemic will have on your business turnover will be over the next year? Please provide your best estimate.

Please enter a percentage identifying the impact on business turnover based on your best estimates for each month below. For example if you expect your business’ turnover to decrease by 10% please enter -10%.

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* 11. Has your business registered for any of the following Government support programs?

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* 12. What support could Council provide to assist your business to reduce the impact of the Covid-19 pandemic?

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