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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
Paying your employees
Support for the self-employed
Paying sick pay
Support for small and medium sized businesses
Paying tax
Support for large businesses
Business rates relief
Support for businesses during lockdown measures
Comments
IMPACT
Moved to Business Closure
-- No Selection --
No Closure
Temporary Closure
Indefinite Closure
Home Working
Impact on Sales or Bookings
-- No Selection --
No Impact
Negative Impact
Positive Impact
Impact on future Sales or Bookings
-- 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
Furloughed:
-- No Selection --
No Change
Increase
Decrease
Job Loss:
-- No Selection --
No Change
Increase
Decrease
Job Gain:
-- No Selection --
No Change
Increase
Decrease