Survey
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Business Owner Name: (Mr./Ms./Mrs.):
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Company Name:
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Company Address:
Street:
City:
State:
OR
WA
ID
MT
CA
NV
WY
Zip:
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Phone:
Email:
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Type of Business:
Agriculture & timber
Bio-technology
Clothing retail
Clothing wholesale
Construction & mining
Finance, real estate, insurance
Food & beverage
Health care
Manufacturing (durable and non-durable goods)
Retail Trade
Service (personal, staffing, consulting, etc.)
Technology (IT)
Transportation
Wholesale trade
Other
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Number of Employees:
1-10 Employees
11-20 Employees
21-50 Employees
51-100 Employees
101-250 Employees
Over 250 Employees
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Interested Level of Involvement (1, 2 or 3):
Political Party Affiliation:
Minority-owned business?
Yes
No
Woman-owned business?
Yes
No
What most frustrates you as a small business owner?