JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Let's Help You Get Back to Business
Getting started is easy. Simply complete this form and we will be in touch to start the process. Questions? Please email
victoriap@thriveed.org
.
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Name
*
Your answer
Organization
*
Your answer
Type of business
*
Your answer
Municipality where business is located
*
City, town, village, etc.
Your answer
Website
Your answer
Phone number
*
Your answer
Email address
*
Your answer
Preferred method of contact
*
Email
Phone
Is your business currently closed?
*
Yes
No
Open with limited services
If your business is currently closed, when did it close?
MM
/
DD
/
YYYY
If your business is currently closed, how many employees did you have the week before you closed?
Your answer
Assistance Requested
*
Choose
A. Information on loan or grant eligibility and details
B. Assistance completing SBA loan application
C. Financial or other business continuity assistance
D. I need assistance with more than one of these (please note below)
E. Information about payment relief for existing loans
F. Other (please note below)
If you selected D. or F. in the previous question:
Your answer
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Glacial Heritage Development Partnership.
Report Abuse
Forms
