COVID-19 (Coronavirus) - Business Support Form

BUSINESS DETAILS

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Email*
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SUPPORT

Business Support helpful at this time





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IMPACT

Has the Business Closed ?
Impact on Sales
Impact on Future Sales
No. of Employees prior to the pandemic:
Full-Time
Part-Time
Current Impact on Employees Predicted in 3 Months
Not Impacted:
Working from Home:
Short Term Lay Off/ Unpaid Leave:
Job Loss:
Job Gain: