#PayItForward St Pete Registration Question Title * 1. Has your business been impacted by the wave of shutdowns and slowdowns caused by government efforts to contain the Coronavirus pandemic? Yes No Question Title * 2. If you have lost customers and revenue, please briefly describe the loss in numbers (e.g., number of typical customers pre-Corona and loss of customers this week OR typical revenue per week since March 16, 2020) (100 words max) Question Title * 3. Do you own the shop where you perform services? Yes No Question Title * 4. If you are the BUSINESS OWNER, please answer the following questions. IF NOT, please skip to the next question. Your name (owner) Business name No. employees (on W2) No. contractors (on W9) No. contractors (other) Addreess (street, city, state, zip) Email Cell phone Business website (if applicable) Question Title * 5. If you are NOT THE OWNER of the place where you perform services, please answer the following questions. Your name Name of business where you work Address of business where you work Cell phone of business owner Your email Your cell phone Question Title * 6. What types of help may you need to get through this crisis period? (please check all that apply) Accessing available emergency loans Accessing available emergency unemployment benefits (for yourself or your workers) Creating a new product/service line Evolving your business model/creating a new business model for this new environment Other (please specify) Question Title * 7. Do you offer mobile, in-home or in-office services? Yes No, but willing to No, unable to at this time Done
