Economic Impact Survey Step 1 of 3 33% Name* First Last Phone*Email* Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Household InformationAll information is completely confidential. We are required by the Small Business Administration to provide this information anonymously to support our funding.The number of adults in my household is:* The number of children in my household is:* Estimated total household income (to the nearest dollar) as:* I am currently in business:* Yes No Are you temporarily closed due to COVID?* Yes No When do you expect to reopen?* Business InformationBusiness Name* Business Launch Date* Approximately when did you launch your business?Business Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Number of Employees (both full-time and part-time):*Please enter a number from 1 to 500.How many of these employees were hired in 2019?*Please enter a number from 1 to 500.What is your business' estimated gross revenue is (to the nearest $):* My business will report a:* Net Profit Net Loss Estimated net profit or loss amount:* What is your business' legal entity?* LLC - Limited Liability Corporation Sole Proprieter S Corp Partnership How has GROW programming helped you to start or run your business?What topics or programs would you like to see GROW offer in the future?Anything else you'd like to share?CAPTCHA
