Launch Pad Weekend Survey

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* 1. Business Name:

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* 2. Address:

Street Address:

City:

State:

Zip:

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* 3. Phone:

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* 4. Website:

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* 5. Email:

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* 6. Owners’ Names:

Owner One:

Owner Two:

Owner Three:

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* 7. Years in Business (please enter a numeric response):

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* 8. Years as Owners (Please enter a numeric response):