MHV Client Survey

IF Started a business, date business was formed*
Income Generated by the Business is:*
Number of Business Owners*
Total Number of Full-Time Employees in 2020. If none put "0"*
Do Not Include 1099 Contractors
Total Number of Part-Time Employees in 2020. If none put "0"*
Do Not Include 1099 Contractors
Total Number of Full-Time Employees in 2021. If none put "0"*
Do Not Include 1099 Contractors
Total Number of Part-Time Employees in 2021. If none put "0"*
Do Not Include 1099 Contractors
The Business Facility is*
Gross Income Generated by the Business in 2020? If none put "0"*
Gross Income Generated by the Business in 2021? If none put "0"*

Did You Receive Funding from either: family, friend, investor, crowd funding, bank, credit union, etc since you first started working with WEDC or since you last completed a survey?*
Loan Information*
Date of Loan Financial Institution/Funder Name Loan Amount Purpose/Use of Funding
Was the funding an SBA loan?*
Did you receive a government contract in the last 3 months?*
Contract Information*
Date Agency or Authority Amount

Your NYS Minority/Women Business Enterprise (MWBE) Certification Status. Overview of criteria http://esd.ny.gov/MWBE/Qualifications.html
What are the top challenges you are facing right now. Such as: Determining Target Market, Aquiring customers, Sufficient Cash Flow, Understanding Financial Statements, Can't Find Employees, Need Financing, etc.
What subjects would you like to learn more about? Also please give us a brief update on your business. Have you pitched an idea to a potential client, developed a new product, received any awards, etc.?
Comments
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Date of Loan	Financial Institution/Funder Name	Loan Amount	Purpose/Use of Funding

Date	Agency or Authority	Amount