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Join other Southern Arizona-based entrepreneurs and small business owners on the FREE AVANZA HUUB.
40
Questions
START
1
Form Source
Used to identify form source in Airtable
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2
Source
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3
Your First Name
*
This field is required.
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4
Your Last Name
*
This field is required.
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5
Your Phone Number
*
This field is required.
Please enter a valid phone number.
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6
Your Email Address
*
This field is required.
example@example.com
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7
How do you prefer to be contacted?
*
This field is required.
Email
Text messaging/SMS
Phone Call
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8
How did you hear about the program?
*
This field is required.
City Staff
HUUB
Search Engine
Social Media
City Website
Recommendation from a friend or colleague
Television
Radio
Newspaper
SBA District
Lender
Business Owner
Groundswell Capital/Tucson IDA website
Other
City Staff
HUUB
Search Engine
Social Media
City Website
Recommendation from a friend or colleague
Television
Radio
Newspaper
SBA District
Lender
Business Owner
Groundswell Capital/Tucson IDA website
Other
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9
Other Referral Source
*
This field is required.
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10
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
18 or younger
19 - 24
25 - 34
35 - 44
45 - 54
55 - 64
65 or older
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11
What gender do you identify as?
*
This field is required.
Male
Female
Non-binary/third gender
Prefer not to say
Other (Please specify)
Male
Female
Non-binary/third gender
Prefer not to say
Other (Please specify)
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12
Other gender
*
This field is required.
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13
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
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
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14
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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15
How many people live at home with you (Conversion)
This field is used to convert the answer to the question above into a numeric value (Airtable)
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16
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
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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17
How do you describe your ethnicity?
*
This field is required.
Select all that apply
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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18
You said Other, What other ethnicity do you identify as?
*
This field is required.
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19
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.
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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20
Do you have any military affiliation?
*
This field is required.
Active Duty
Military Family Member
Military Spouse
Veteran
Member of reserve
Service-disabled veteran
Member of the National Guard
None
Active Duty
Military Family Member
Military Spouse
Veteran
Member of reserve
Service-disabled veteran
Member of the National Guard
None
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21
Do you identify as LGBTQ+?
*
This field is required.
Yes
No
Prefer not to answer
Yes
No
Prefer not to answer
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22
Do you consider yourself to be an individual with disability or disabilities?
*
This field is required.
We request this information to determine your eligibility for grants and best serve you.
Yes
No
Prefer not to answer
Yes
No
Prefer not to answer
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23
What is your marital status?
*
This field is required.
Single
Married
Widowed
Divorced
Separated
Living with partner
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24
Name of Your Business
*
This field is required.
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25
Business Address
*
This field is required.
Street Address
Street Address Line 2
City
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Please Select
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
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
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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26
City
*
This field is required.
Avanza
Other
Avanza
Avanza
Other
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27
What is your business structure?
*
This field is required.
Sole Proprietorship
LLC
Partnership
Corporation
501(c)3 non-profit organization
Other
Not sure
Sole Proprietorship
LLC
Partnership
Corporation
501(c)3 non-profit organization
Other
Not sure
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28
Is your business registered with the State of Arizona?
*
This field is required.
TRUE
FALSE
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29
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
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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30
Other industry
*
This field is required.
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31
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
1
2
3
4
5
6
7
8
9
10
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32
Current State of Business (Conversion)
This field is used to convert the answer to the question above into a numeric value (Airtable)
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33
How many employees currently including yourself?
*
This field is required.
1
2-5
6-10
11-20
21-50
51+
1
2-5
6-10
11-20
21-50
51+
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34
Is this a home based business?
*
This field is required.
TRUE
FALSE
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35
How long has your business had your paying customers?
*
This field is required.
0 months
Under 12 months
1-2 years
3-5 years
6-10 years
10+ years
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36
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
Loan Application Support
Marketing & Sales
Operations
Product & Service Development
Web & Tech
Non-profit
Other
Business Strategy
Finance
HR
Legal
Loan Application Support
Marketing & Sales
Operations
Product & Service Development
Web & Tech
Non-profit
Other
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37
What other area not listed are you interested in?
*
This field is required.
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38
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
Loan Application Support
Marketing & Sales
Operations
Product & Service Development
Web & Tech
Non-profit
Other
Business Strategy
Finance
HR
Legal
Loan Application Support
Marketing & Sales
Operations
Product & Service Development
Web & Tech
Non-profit
Other
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39
What other area not listed are you interested in?
*
This field is required.
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40
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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41
What other resources are you interested in?
*
This field is required.
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42
Please describe the types of assistance that would be most helpful for your business?
*
This field is required.
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43
Is your business 51% or more owned by a US citizen or green card holder?
*
This field is required.
51% or more is owned by a US citizen
51% or more is owned by a green card holder
None of the above
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44
Is your business 51% or more women-owned, veteran-owned, or minority-owned?
*
This field is required.
51% or more women-owned
51% or more veteran-owned
51% or more minority-owned
None of the above
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45
For your most recent full business year, what was your gross revenue/sales?
*
This field is required.
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46
Estimated annual expenses:
*
This field is required.
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47
Have you ever tried to apply for funding (for example, a business loan) for your business in the past but were not successful?
*
This field is required.
Yes
No
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48
What types of funding/capital have you used for your business?
*
This field is required.
Credit Cards
Traditional Loans
Micro-loans / Non-Profit Loans
Grants
Lines of Credit
Friends and Family
Venture Capital/ Investors
None
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49
If you were to look for a loan for your business, what would be the most important to you?
*
This field is required.
Select all that apply
Low-interest rate
No collateral requirement
No credit requirement
Flexible repayment schedules
Easy application process
Trusted organization
Online payments
None / Not Applicable
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50
What resources would you like to see be more accessible to small businesses in Arizona?
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51
In what areas of business development would you be most interested in learning more?
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Select all that apply
Start-up assistance (how do I start a small business?)
Business Plan
Financing/Capital (applying for a loan, building equity)
Managing business
HR, employee management
Customer relationship
Business Accounting/Budget
Cash Flow Management
Tax Planning
Marketing/Sales (promotion, market research, pricing etc)
Government contracting (including certifications)
Franchising
Buy/Sell Business
Cyber security/Cyber Awareness
Technology/Computers
eCommerce (using the internet to do business)
Legal Issues (such as should I incorporate?)
International Trade Intellectual Property
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52
I Agree with the Terms and Conditions and the EULA of AVANZA HUUB.
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The EULA can be viewed via the following link:
https://avanza.myhuub.com/eula/
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