Bexar County Forms

5. 
10. 1. What is the name of your business?*
12. 2. Which of the following areas is your business located?*
    -- Select One --Alamo HeightsBalcones HeightsCastle HillsChina GroveConverseElmendorfFair Oaks RanchGrey ForestHelotesHill Country VillageHollywood ParkKirbyLeon ValleyLive OakOlmos ParkSan AntonioSchertzSelmaShavano ParkSomerestTerrell HillsUniversal CityVon OrmyWindcrestUnincorporatedOther
14. Please enter your zip-code:*
16. 3. Which of the following best describes your industry?*
    -- Select One --Arts and HumanitiesConstructionConsultingDaycare/EducationFinance and InsuranceFood ServicesGoods and CommoditiesHospitalityManufacturingNon ProfitPersonal CarePersonal ServicesProfessional ServicesReligious ServicesRestaurantsRetailSports and FitnessStaffingTechnology and Cyber SecurityTrucking and TransportOther Services
18. For questions 4-6, the term "employees" does not include contractors.
20. 4. How many employees (full-time and part-time) are currently working for your business?*
    -- Select One --No employees/self-employed1-5 employees6-10 employees11-15 employees16-20 employees21-50 employees51-100 employees101-150 employees151-200 employees201-250 employees251-300 employees301-350 employees351-400 employees401-450 employees451-500 employees501 employees or morePrefer not to answer
22. 5. How many full-time and part-time employees were terminated due to the impact of COVID-19?
24. Full-Time*
25. Part-Time*
27. 6. How many full-time and part-time employees have you been able to hire since January 2021?
29. Full-Time*
30. Part-Time*
32. 7. Which of the following certifications apply to your business? [Check all that apply]*

    1. Small Business Enterprise (SBE)
    2. Minority Business Enterprise (MBE)
    3. Historically Underutilized Business (HUB)
    4. Disadvantaged Business Enterprise (DBE)
    5. African-American Business Enterprise (AABE)
    6. Hispanic American Business Enterprise (HABE)
    7. Native American Business Enterprise (NABE)
    8. Veteran-Owned Business Enterprise (VBE)
    9. Asian Business Enterprise (ABE)
    10. Women-Owned Business Enterprise (WBE)
    11. Emerging Small Business Enterprise (ESBE)
    12. Asian-Pacific American Business Enterprise (ASBE)
    13. Disabled Individual Business Enterprise (DIBE)
    14. American Indian Business Enterprise (AIBE)
    15. SBA Program for Development of Women-Owned Businesses (8M)
    16. Service-Disabled Veteran-Owned Small Business (SDVOBE)
    17. SBA Program for Development for Small Businesses in HUB Zones (8A)
    18. Lesbian, Gay, Bisexual and/or Transgender-Owned Business Enterprise (LGBTBE)
    19. None of the above
34. 8. How has your business revenue changed since March 2020?*

    1. Decrease of 10% or less
    2. Decrease of 11%-20%
    3. Decrease of 21%-30%
    4. Decrease of 31%-40%
    5. Decrease of 41%-50%
    6. Decrease of 51% or more
    7. No change in revenue
    8. Revenue has increased
    9. Prefer not to answer
36. If revenue has increased, please specify:
38. 9. Which of the following COVID-19 measures do you apply at your business? [Check all that apply]*

    1. Use of face coverings
    2. Social distancing
    3. Temperature checks
    4. Hand sanitizer stations
    5. None of the above
    6. Prefer not to answer
40. 10. Is your business offering the same products and services as it did before the COVID-19 pandemic?*

    1. Yes
    2. No
42. If no, what new products and services does your business offer?
44. 11. Have you been approved for any of the following: [Check all that apply]*

    1. SBA Paycheck Protection Program
    2. SBA Emergency Economic Injury Disaster Loans
    3. Bexar County LiftFund Loan
    4. Bexar County LiftFund Grant
    5. City of San Antonio LiftFund Loan
    6. Did not apply
    7. None
46. 12. Did any of the following assist you with filing your loan or grant application? [Check all that apply]*

    1. UTSA Minority Business Development Agency
    2. UTSA PTAC
    3. UTSA SBDC
    4. SAGE
    5. SCORE
    6. LiftFund
    7. LaunchSA
    8. Chamber of Commerce
    9. None of the above
48. 13. Has your business significantly increased its use of any of the following digital technologies since the COVID-19 pandemic began? [Check all that apply]*

    1. Facebook
    2. Google Hangouts
    3. LINE
    4. Microsoft Teams
    5. WebEx
    6. WhatsApp
    7. Zoom
    8. None
    9. Other
50. If other, please specify:
52. 14. Please describe the impact of COVID-19 on your business.*
54. 15. How would you rate the level of impact that the COVID-19 pandemic has had on your business?*

    1. Large negative effect
    2. Moderate negative effect
    3. Little or no effect
    4. Moderate positive effect
    5. Large positive effect
56. 16. In your opinion, how much time do you think will pass before your business returns to normal levels of operations?*

    1. 1 month or less
    2. 2-3 months
    3. 4-6 months
    4. More than 6 months
    5. I think my business will not return to a normal level of operation.
    6. There has been no effect on the level of operation at my business.
    7. My business has returned to its usual level of operations.
    8. Prefer not to answer
58. 17. What are the ways in which city, county, and state partners can assist your business for recovery from the COVID-19 pandemic?*
60. 18. Please provide your email address:*
Leave This Blank:


62. 1. Receive an email copy of this form.
63. Email address

    This field is not part of the form submission.

64. Submit

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