Full Name * Business Name * Business Title / Position * Owner Partner Operator / Manager Employee What Type Of Business Do You Run? * Retail Clothing/Fashion Cafe / Bakery Casual Eatery Restaurant Grocery / Convenience Night Life / Venue Bar Professional Services Essential Services Lifestyle & Wellness Medical Business Email * Business Website Social Media Business Phone Number * (###) ### #### Business Address Address 1 Address 2 City State/Province Zip/Postal Code Country Years operating as a business in the neighborhood * Less than 1 year 1-3 years 3-5 years 6-10 years 10+ years Business Structure Sole Proprietor Partnership Corporation Estimated Annual Revenue (USD) * Under $1M $1M to 3M $3M to 5M $5M+ I Do Not Know Prefer Not To Answer Number of employees at your location * 1-3 4-9 10-19 20+ Please share your business related concerns. Check all that apply. * Rising Rent / Property Expenses Foot Traffic Regulatory Compliance & Permits Parking Vandalism Security & Crime Sanitation / Garbage Pests / Vermin Access To Capital Economic Uncertainty Competition from Large Chains Homeless / Vagrancy Noise Public Transportation / Access Unlicensed Street Vendors Taxes Permits Excessive Fees Unresponsive City Services Municipal Communication What are the biggest challenges for your business? Check all that apply. * Sales / Revenue New Customers Access To Capital Economic Conditions Rising Expenses Staffing / Employee Retention What activities or events would you be interested in NW-MBA supporting? Check all that apply. * Owners Text Group for Real Time Alerts & Communications Business Improvement Districts Chamber of Commerce Local Community Board Referrals for Trusted Professional Services (Electricians, Handymen, Cleaners, et cetera) Local Insider Neighborhood Discounts for Fellow Members Sanitation Monitoring & Fee Negotiation Food & Culinary Retail Block Party Holiday Decorations Preferred Service Vendors Thank you!
