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* 1. Company Name

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* 2. Zip Code

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* 4. Clients/Customer Base

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* 5. How many people does your business employ?

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* 6. How long has your company been in operation?

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* 7. What is the overall impact that the pandemic has had on your business?

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* 8. Throughout the pandemic, your business has

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* 9. What is your company's annual revenue (pre-pandemic)?

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* 10. How does your company's revenue this year compare to that of 2019?

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* 11. Has your company incurred new debt during the pandemic?

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* 12. How has the composition of your staff (number of paid employees) changed during the pandemic?

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* 13. What scheduled payments has your company missed in 2020? Check all that apply.

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* 14. Which of the following struggles has your business experienced as a result of the pandemic? Check all that apply.

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* 15. What type of government assistance or relief did you receive as a result of the pandemic?

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* 16. I believe that my company has received adequate relief from the government.

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* 17. Why did you company not apply for government assistance or relief as a result of the pandemic? Check all that apply.

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* 18. My company has been unfairly denied adequate relief because we are Black-owned.

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* 19. How confident are you that your business will survive the pandemic?

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* 20. Continuing on your current trajectory and that of the pandemic, how long will it take your company to return to pre-pandemic operations?

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* 21. Are you a member of a local chamber of commerce?

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* 23. What policies do you feel are most effective and beneficial with respects to supporting your business and other Black-owner businesses? Optional.

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* 24. How can your company best be helped in the immediate future? Optional.

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* 25. Email

 
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