Question Title

* 1. Contact Information

Question Title

* 2. In which industy is your business?

Question Title

* 3. How many employees does your business have when fully staffed?

Question Title

* 4. How is your business being affected by COVID-19? (Check all that apply)

Question Title

* 5. Approximately, how much revenue have you lost due to COVID-19?

Question Title

* 6. Have you been forced to lay off employees due to COVID-19?

Question Title

* 7. Have you had to close your business due to COVID-19?

Question Title

* 8. Do you have business interruption insurance?

Question Title

* 9. Do you have the financial capacity to make payroll?

Question Title

* 10. How many days of cash on hand does your business have?

Question Title

* 11. How many months of rent do you have on hand (if leasing)? (optional)

Question Title

* 12. Do you have the technology infrastructure for you and your staff to work remotely?

Question Title

* 13. Do you have a business continuity plan (an outline of procedures to prevent damage, maintain productivity and recover in the event of a national emergency or disaster)?

Question Title

* 14. What is the gender of the majority (51%+) of the businesses owners?

Question Title

* 15. What is the ethnicity of the business owners? (Check all that apply)

T