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Business disruption assessment
General information
*
1.
Name
(Required.)
*
2.
Your job title/position
(Required.)
*
3.
Company name
(Required.)
*
4.
Email address
(Required.)
5.
Phone number
6.
Website
*
7.
Select the industry category (or categories) that is most applicable to your business:
(Required.)
Agriculture, Forestry and Fishing
Mining
Manufacturing
Electricity, Gas, Water and Waste Services
Construction
Wholesale Trade
Retail Trade
Accommodation and Food Services
Transport, Postal and Warehousing
Information Media and Telecommunications
Financial and Insurance Services
Rental, Hiring and Real Estate Services
Professional, Scientific and Technical Services
Administrative and Support Services
Public Administration and Safety
Education and Training
Health Care and Social Assistance
Arts and Recreation Services
Other Services
8.
Define your business ownership structure
Sole proprietorship
Partnership
Corporation
Limited Liability Company
*
9.
Where is your business headquartered?
(Required.)
10.
Where else does your business operate? Please list domestic and/or international locations if applicable
11.
If international, do you operate in foreign jurisdictions or simply export through third party logistics?
12.
Please list total number of employees by region in New Zealand
13.
Please list total number of employees by country (if applicable)
14.
Total number of full-time employees
15.
Total number of part-time employees
16.
Total number of casual or seasonal workers
17.
Percentage of salaried employees
18.
Percentage of contracted employees
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