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Application for Business Assistance
Recognizing the hardships imposed on our businesses by the COVID-19 Virus, we are coordinating volunteer advice and services for our local businesses to assist them in navigating these difficult times.
Date and Time
Format: M/d/yyyy
Name Block - Full
Title
First Name
Last Name
Suffix
Business Name
*
Business Type/Industry
*
Approximate # of Full Time Employees
*
Approximate # of Part Time Employees
*
Specific questions or assistance needed
*
Is there a related or affiliated business?
*
Contact Information including phone and direct email
*
