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* 1. Please list your business or organization name exactly how you would like it listed in our marketing, informational and promotional materials.

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* 2. Is your business currently open, even with limitations or restrictions re: state and local COVID related directives?

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* 3. If you are currently open, please list specific hours, products and services available and any limitations or restrictions on such. Ex: Open M-F, 9 to 5, walk-ins only on Tuesday, no more than 5 people in waiting room, call ahead for availability, take-out and delivery only, etc.)

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* 4. If you responded "no" to question one, do you have plans to reopen?

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* 5. If you responded "no" to question one but plan to re-open, what are your re-opening plans? Be specific. Date of reopening, hours (each day), limited products or services, customer requirements, safety protocols you'll have in place, etc.

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* 6. If you are currently open but have upcoming changes to your hours, products and/or services, please list.  Ex: If you are a restaurant or retailer that is currently open but has state restrictions changing soon that will affect your hours and procedures. Please list specifically when changes will take effect and specifically what they are. Ex: On May 31st, we will open our dining room but with 50% capacity, no reservations, those waiting in line will be required to follow social distancing, etc.

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* 7. Please list current contact information for customers or clients:

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* 8. If you are in need of information or assistance, please mark the topics or areas below that uou would like to receive information on.

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* 9. Contact person for questions regarding this survey:

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* 10. Contact phone and email address:

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