REDC Covid-19 Disaster Questionnaire Question Title * 1. Contact Information Name Business/Company Business Address Business City/Town Business ZIP/Postal Code Email Address Phone Number Question Title * 2. Status Is your business still open? Are you considering closing your business because of the virus restrictions? Question Title * 3. What is your industry? Childcare Construction Hospitality (restaurant, catering, hotels) Entertainment (theaters, cultural institution, etc.) Manufacturing Distribution/Logistics/Warehousing Personal Services (barber shop, nail salon, dry cleaner, etc.) Professional Services Retail Social Services Other (please specify) Question Title * 4. Please describe your business loss due to COVID-19. Question Title * 5. What was your annual business revenue last year? <$100K $100K-$299K $300K-$499K $500K-$999K $1M-$2.9M $3M-$4.9M $5M-$9.9M $10M+ Question Title * 6. Please estimate any revenue decline you've experienced as a result of COVID-19, if applicable. 0% <10% 10-20% 21-30% 31-40% 41-50% 51-60% 61-70% 71-80% 81-90% 91-100% Question Title * 7. How many employees do you have did you have February 1, 2020? 0 1-5 6-10 11-20 21-50 51-99 100-499 500+ Question Title * 8. How many employees do you have now? 0 1-5 6-10 11-20 21-50 51-99 100-499 500+ Question Title * 9. Layoffs Have you laid off any employees? Are you considering laying off any additional employees? Question Title * 10. What is your critical concern right now? Is there anything we can pass on to the State of NH that would help? Done