Phoenix Onboarding

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Form SourceUsed to identify form source in Airtable
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Source
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Your First Name* This field is required.
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Your Last Name* This field is required.
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Your Job Title* This field is required.
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Name of Your Business* This field is required.
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Your Phone Number* This field is required.
Please enter a valid phone number.
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Your Email Address* This field is required.
example@example.com
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Business Address* This field is required.
Street Address
Street Address Line 2
City
State
Zip Code
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
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How do you prefer to be contacted?* This field is required.
Email
Text messaging/SMS
Phone Call
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City* This field is required.
Phoenix
Other
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Zip Code:* This field is required.
85001
85002
85003
85004
85005
85006
85007
85008
85009
85010
85011
85012
85013
85014
85015
85016
85017
85018
85019
85020
85021
85022
85023
85024
85026
85027
85028
85029
85030
85031
85032
85033
85034
85035
85036
85037
85038
85040
85041
85042
85043
85044
85045
85046
85048
85050
85051
85053
85054
85060
85061
85062
85063
85064
85066
85067
85068
85069
85070
85071
85072
85074
85076
85078
85079
85080
85082
85083
85085
85086
Other
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How did you hear about the program?* This field is required.
City Staff
CO+HOOTS
Search Engine
Social Media
City Website
Recommendation from a friend or colleague
Television
Radio
Newspaper
Other
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Other Referral Source* This field is required.
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By submitting this application, I affirm that I am 18-years-old or older.* This field is required.
TRUEFALSE
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How are you feeling about the current state of your business?* This field is required.1=I may need to close, 5= Not sure, 10= Great
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2
3
4
5
6
7
8
9
10
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Current State of Business (Conversion)
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How has COVID-19 impacted your business?* This field is required.
Positively
Negatively
Both positively & negatively
Neither - not impacted
Prefer not to answer
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Do any of these options describe the impact?* This field is required.
Lost revenue
Revenue stayed flat
Increased revenue
At risk of closing
Planning to expand (adding jobs, adding square footage, moving to a new building, expanded operations)
None
Other
Prefer not to answer
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You said other* This field is required.Please describe how your business was impacted
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What % of income was lost in the first three months following the start of the pandemic.* This field is required.
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What is your 1st priority area that you are looking for support on in your business?* This field is required.
Business Strategy
Finance
HR
Legal
Marketing & Sales
Operations
Product & Service Development
Web & Tech
Non-profit
Other
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What other area not listed are you interested in?* This field is required.
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What is your 2nd priority are that you are looking for support on in your business?* This field is required.
Business Strategy
Finance
HR
Legal
Marketing & Sales
Operations
Product & Service Development
Web & Tech
Non-profit
Other
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What other area not listed are you interested in?* This field is required.
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Please describe the types of assistance that would be most helpful for your business?* This field is required.
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Check off your business to-do list! City of Phoenix businesses qualify for up to 10 free hours with an advisor who will take action in moving your business forward. Would you like to apply for the one on one support program? We’ll send you an email with a link to a pre-filled form to complete, to help speed up the application process.* This field is required.You can learn more about the program here: https://phoenix.myhuub.com/phoenix-technical-assistance/
Yes
No
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Here are some of the resources that are available on the HUUB. What resources are you interested in for your business?* This field is required.
On-demand courses
Grant opportunities
Networking with other businesses in my community
Directory of resource organizations in my community
Be able to attend LIVE events via a community calendar
Be able to connect directly with City staff
Business bootcamp/incubator programs
Mastermind groups
1:1 Business consulting support
Other
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What other resources are you interested in?* This field is required.
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How many employees currently including yourself?* This field is required.
1
2-5
6-10
11-20
21-50
51+
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How many employees including yourself pre-covid?* This field is required.
1
2-5
6-10
11-20
21-50
51+
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Is this a home based business?* This field is required.
TRUEFALSE
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How long have you been in business?* This field is required.
Under a year
1-2 years
3-5 years
6-10 years
10+ years
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Date your Business first opened* This field is required.
Date
Year
Month
Day
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Does your business have more than one location?* This field is required.
TRUEFALSE
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If yes, how many locations?* This field is required.
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What is your business structure?* This field is required.
LLC
Sole Proprietorship
Corporation
Partnership
501(c)3 non-profit organization
Independent Contractor
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Is your business registered with the State of Arizona?* This field is required.
TRUEFALSE
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What business industry?* This field is required.
Agriculture
Mining
Utilities
Construction
Manufacturing
Wholesale Trade
Retail Trade
Transportation
Warehousing
Information
Finance and Insurance
Real Estate Rental and Leasing
Professional Services
Management of Companies
Administrative Support Services
Educational Services
Health Care, Social Services, Child Care
Arts, Entertainment, Recreation (also Fitness Ctrs, Dance Studios)
Lodging and Restaurants (also Catering and Event Centers)
Other Services (Salons, Massage, Repair Svcs, Cleaners, Non-Profits)
Other
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Other industry* This field is required.
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Your annual gross revenue for 2022?* This field is required.
My business was not open/$0
$9,999 or less
$10,000 - $24,999
$25,000 - $49,999
$50,000 - $74,999
$75,000 - $99,999
$100,000-$249,000
$250,000-$499,999
$500,000-$749,999
$750,000-$999,999
$1,000,000-$4,999,999
$5,000,000-$9,999,999
$10m+
I prefer not to answer
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...and your annual gross revenue for 2023?* This field is required.
My business was not open/$0
$9,999 or less
$10,000 - $24,999
$25,000 - $49,999
$50,000 - $74,999
$75,000 - $99,999
$100,000-$249,000
$250,000-$499,999
$500,000-$749,999
$750,000-$999,999
$1,000,000-$4,999,999
$5,000,000-$9,999,999
$10m+
I prefer not to answer
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What's your age range?* This field is required.
18 or younger
19 - 24
25 - 34
35 - 44
45 - 54
55 - 64
65 or older
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What gender do you identify as?* This field is required.
Male
Female
Non-binary/third gender
Prefer not to say
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Household income?* This field is required.
Under $20,000
$20,001 - $40,000
$40,001 - $60,000
$60,001 - $80,000
$80,001-$100,000
$100,001-$120,000
$120,001-$140,000
$140,001-$160,000
$160,000 or more
I prefer not to answer
I have successfully proven the market and need and I am looking to scale to multiple locations.
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How many people, including yourself, live at home with you?* This field is required.
1
2
3
4
5
6
7
8
9
10
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How many people live at home with you (Conversion)
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Which language do you feel most comfortable speaking?* This field is required.
Albanian / Shqip
Amharic / አማርኛ
Arabic / العربية
Armenian / Հայերեն
Bengali / বাংলা
Bosnian / Bosanski
Bulgarian / Български
Burmese / မြန်မာဘာသာ
Chinese (Simplified) / 中文(简体)
Chinese (Traditional) /中文(繁體)
Croatian / Hrvatski
Czech / Čeština
Dutch / Nederlands
English
Farsi / فارسی
French / Français
German / Deutsch
Greek / Ελληνικά
Gujarati / ગુજરાતી
Haitian Creole / Kreyòl Ayisyen
Hebrew / עברית
Hindi / हिन्दी
Hmong / Hmoob
Hungarian / Magyar
Igbo / Igbo
Ilocano / Ilokano
Indonesian / Bahasa Indonesia
Italian / Italiano
Japanese / 日本語
Khmer / ខ្មែ រ
Korean / 한국어
Lao / ພາສາລາວ
Lithuanian / Lietuvių
Malayalam / മലയാളം
Marathi / मराठी
Navajo / Diné
Nepali / नेपाली
Polish / Polski
Portuguese / Português
Punjabi / ਪੰਜਾਬੀ
Romanian / Română
Russian / Русский
Serbian / Srpski
Sinhala / සිංහල
Slovak / Slovenčina
Somali / Soomaali
Spanish / Español
Swahili / Kiswahili
Tagalog / Tagalog
Tamil / தமிழ்
Telugu / తెలుగు
Thai / ไทย
Tigrinya /ትግርኛ
Turkish / Türkçe
Twi / Twi
Ukrainian / Українська
Urdu / اردو
Vietnamese / Tiếng Việt
Yiddish / ייִדיש
Yoruba / Yorùbá
Spanish
English, Spanish
Chinese (Cantonese)
Spanish, English
Chinese (Mandarin), English
Korean, English
Chinese (Mandarin)
Vietnamese
English, Korean
Korean
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How do you describe your ethnicity?
Hispanic, Latino or Spanish origin
Native American or Alaska Native
Asian/Pacific Islander
Black or African American
Native Hawaiian or other Pacific Islander
White/Caucasian
Don't wish to answer
Other
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You said Other, What other ethnicity do you identify as?* This field is required.
51
What's the highest level of education you've completed?* This field is required.
Less than High School
High School
Some College / University
College Diploma / Certificate
Undergraduate Degree
Masters / Graduate Degree
Doctorate
I prefer not to answer.
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Do you have any military affiliation?* This field is required.
Active Duty
Military Family Member
Military Spouse
Veteran
None
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Do you identify as LGBTQ+?* This field is required.
Yes
No
Prefer not to answer
54
Do you consider yourself to be an individual with disability or disabilities?* This field is required.
Yes
No
Prefer not to answer
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I Agree with the Terms and Conditions & the EULA of the PHXbizConnect HUUB.* This field is required.The EULA can be viewed via the following link: https://phoenix.myhuub.com/eula/
Yes
No
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