APPLICATION Organization NameStreet AddressCityState/ProvinceZIP / Postal CodeContact NamePhoneContact TitleEmail AddressWhich category best describes your business?RetailNon ProfitRestaurantWellnessDo you rent or own your building?RentOwnDateDate your physical location closed to the public.NumberNumber of paid employees prior to closing.NumberHow many employees consider your organization their sole household employer.NumberApproximate number of people who patronized your business in 2019.TextHow has the "Safer at Home" order impacted your business financially? (100 words or less) Specific examples and financial assessments are appreciated.0 / 800TextHow will impact relief funds help your business and our community? (100 words or less) Specific examples and financial assessments are appreciated.0 / 800Submit Application
