THIS IS A TEST VERSION OF THIS SURVEY
Responses will NOT be recorded.

Quaboag Valley Community Development & Business Assistance Corporation Survey
RequiredRequired Question(s)
Quaboag Valley CDC is seeking input from Business Owners in the following towns: Belchertown, Brimfield, Brookfield, Charlton, Dudley, East Brookfield, Hardwick, Holland, Monson, New Braintree, North Brookfield, Oxford, Palmer, Spencer, Southbridge, Sturbridge, Wales, Ware, Warren, West Brookfield.
 
1.
Please enter the information indicated below.

By entering my personal information, I consent to receive email communications from the survey author's organization based on the information collected.

First Name:
Last Name:
Company Name:
Work Phone:
Email Address:
emailaddress@xyz.com
Address 1:
Address 2:
City:

Required 2.
Is the business located in one of these towns?
Brookfield, East Brookfield, North Brookfield, Spencer, West Brookfield, Southbridge or Sturbridge
Belchertown, Brimfield, Holland, Monson, Palmer, Wales, Ware
Hardwick, New Braintree, Warren
Other  
Required 3.

What is your household income?

$0-$10,000
$10,000-$25,000
$25,000-$50,000
$50,000-$60,000
$60,000-$70,000
$70,000-$80,000
$80,000-$90,000
$90,000-$100,000
$100,000 or more
Required 4.
How many people live in your household?
 

50 characters left.
5.
Can you provide financial reports, for at least one full year, showing income, expenses, business assets and debts?
Yes, for 2019
Yes, for 2018
No
Other  
6.
How many employees did your company have prior to the Coronavirus outbreak (including owners)?
0 to 5
5 or more
7.
How many employees are currently on your payroll (including owners)?
0-5
5 or more
8.
Does the business have a brick-and-mortar location?
Yes
No
9.
How would you categorize your business?
Attractions / Amusements
Child Care Services
Cleaning Services
Construction
Consultant Services
Creative / Arts
Health and Wellness Services
Hospitality
Insurance
Manufacturing
Media
Non-Profit
Personal Care (Beauty / Cosmetology)
Professional Services
Real Estate
Restaurant/prepared food sales
Retail
Technology
Transportation
Travel
Other