GABCC Business Impact Survey
Business Name
Name
First Name
Last Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
1. How is/was your business impacted by Covid-19?
2. What percentage(%) of revenue did your business lose during the Pandemic(skip if no revenue loss)?
3. Please Identify Your Race:
Native Hawaiian or Other Pacific Islander
African American or Black
White
Hispanic
Asian
4. Are you working to close your business or transition to a new business?
5. What type of funding have you received for your business during Covid-19?
PPP
EIDL Loan
EIDL Advance
City of Augusta Program
Bank Funding
No Additional Funding Received During Covid-19
Other
6. Did you retain all employees or had to lay off staff?
Retain
Lay Off
Hired
Self-Employed
Other
7. How many employees were impacted from question 6?
8. Please select your Business Industry.
Please Select
Banking
Business Services
Food Service
Agriculture & Forestry/Wildlife
Construction/Utilities/Contracting
Education
Finance & Insurance
Health Services
Personal Services
Real Estate & Housing
Safety/Security & Legal
Transportation
Submit
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