COVID Navigation Intake
1.
Please enter your name.
*
First Name
Last Name
2.
What is your company's name?
3.
What is your preferred email address to receive our email communications?
*
4.
What is your work phone number?
5.
How has the COVID crisis impacted your business?
6.
What are your needs?
Loan options
Grant opportunities
Help getting service or product online
Employee Mgmt Advice
Getting bills delayed
Legal Support
Urgent cash for personal needs
7.
Please describe any additional needs you may have.
8.
How many part-time jobs (less than 35 hours per week) does your business have?
9.
How many full-time paid employees (35 hours or more per week) does your business have?
10.
What legal structure do you have for your business? (Sole proprietorship, LLC, Partnership, Corporation etc.) I
Sole proprietorship
LLC
Partnership
Corporation
Cooperative
Not for profit
None
Other