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COVID-19 (Coronavirus) - Business Support Form
BUSINESS DETAILS
Registered Name
*
Postcode:
Building Name:
Secondary Name:
Street:
District:
Town:
County:
Forename
*
Surname
*
Email
*
Telephone
Sector
-- No Selection --
Manufacturing
Construction
Digital, Creative and Technology
Health & Life Sciences
Maritime & Logistics
Professional & Business Services
Retail
Tourism & Hospitality
Other
Employer Size Band
-- No Selection --
Sole Trader
Micro 2-10
Small 11-50
Medium 51-250
Large 251+
SUPPORT
Business Support helpful at this time
General Advice & Guidance
Cashflow Issues
Staffing / Employment
Cancelled Orders
SME Loan
Increased Sales
Retail, Hospitality & Leisure Grant (£25k)
Supply Chain Issues
Small Business Grant (£10k)
Remote Working
Business Rates
Comments
IMPACT
Has the Business Closed ?
-- No Selection --
No Closure
Temporary Closure
Indefinite Closure
Home Working
Impact on Sales
-- No Selection --
No Impact
Negative Impact
Positive Impact
Impact on Future Sales
-- No Selection --
No Further Impact
Negative Impact
Positive Impact
Unknown
No. of Employees prior to the pandemic:
Full-Time
Part-Time
Current Impact on Employees
Predicted in 3 Months
Not Impacted:
-- No Selection --
No Change
Increase
Decrease
Working from Home:
-- No Selection --
No Change
Increase
Decrease
Short Term Lay Off/ Unpaid Leave:
-- No Selection --
No Change
Increase
Decrease
Job Loss:
-- No Selection --
No Change
Increase
Decrease
Job Gain:
-- No Selection --
No Change
Increase
Decrease