Application
Company Name
Contact email
Company address
Company social media handles (Facebook, Twitter, or Instagram)
Number of employees
Type of business
Select a business type
Online
Brick & Mortar
Both
Other
Company overview / business product or service description
How will the relief funds be used
Contact full name
Company phone
Company website
How long in business
Business Structure
Select a business structure
Sole Proprietorship
Partnership
Corporation
Limited Liability Company
Other
Business annual revenue
Select an annual revenue
$0 – $24,999
$25,000 - $49,999
$50,000 - $74,999
$75,000 - $99,999
$100,000 - $249,999
$250,000 - $499,999
$500,000 - $999,999
$1M+
Company goals / objectives
Company successes
Company challenges (select all that apply)
business budgeting
negotiating
business debt
data protection
time management
cash flow
poor credit score
lack of business plan
customer service
managing growth
hiring employees
marketing
access to loans/funding
lack of business network
managing social media
lack of innovation
business legal services
sales
product/service pricing
online sales
shipping/distribution
payroll/salaries
supplier purchasing
work/life balance
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