* 1. Are you male or female?

* 2. What is the highest level of school you have completed or the highest degree you have received?

* 3. Are you White, Black or African-American, American Indian or Alaskan Native, Asian, Native Hawaiian or other Pacific islander, or some other race?

* 4. What is your age?

* 5. Describe your affiliation with Alaska Small Businesses

* 6. What Community do you reside in?

* 7. What are the greatest CURRENT needs of your current/aspiring business? Please mark all that apply.

* 8. Please check the category of annual gross sales for your business' last recorded year. If you are a start up business, please estimate your annual gross sales.

* 9. Oftentimes, we see business that want to grown, but for some reason do not. If you are one of those businesses, please offer some insight. Please mark all that apply.

* 10. What type of training and/or assistance would you like to have? Please mark all that apply.

* 11. If training and/or assistance were made available to address your needs, what is the preferred delivery method? Please mark all that apply.

* 12. What types of technology are typically used in your business? Please mark all that apply.

* 13. If you are seeking a small business loan, what do you think your biggest impediment is?

* 14. Micro Business loans under $10,000 are usually for assisting start-ups, for initial inventory, or raw materials. If you need a micro business loan what might it be for?

* 15. What type of business do you think would be successful in your community or what type of business would you like to start?

* 16. What is your first and Last name?

* 17. What is your Business name?

* 18. What is your Mailing address?

* 19. At what email address would you like to be contacted?

T