Form

Please fill out this form if you are seeking assistance from Minnesota Avenue Main Street in response to the COVID19 situation in DC.

Small businesses located on Minnesota Avenue NE from East Capitol St NE to Nannie Helen Burrough Avenue NE may be eligible for grant assistance from our organization.

We will be in touch within 48 hours. Please be patient, as we are working remotely and trying to assist as many businesses as we can. You can sign up to receive email updates from us for business owners at https://minnesotaavemainstreet.org/contact. On the contact form, please select that you are a business in Ward 7. Thank you for completing this form!

First name

Last name

Company name

Type of business or organization

Email*

Phone number*

State (Business)

City

Country/Region

Ward (Business)

Please verify your business is located within the Minnesota Avenue Main Street boundaries. Enter your address to determine eligibility for assistance here.

What is the immediate impact of the COVID-19 public health emergency on business revenue?

Please upload a revenue statement, a cash register sales receipt, or other document from the past week, and a comparative document from a previous week or the same time period last year, so we can evaluate how much revenue your business has lost. Any documentation in profit or revenue loss you can provide will be helpful. Please use a Word, Excel, or PDF format.

What do you expect the impact will be over the next 30 days? Please also estimate your projected monthly expenses, even if it is a very rough number, the MINIMUM amount that your business would need for operating costs for a month. What do you normally spend on rent, utilities, staff costs, taxes, etc, in a month?

What other business decisions have you made to prepare for the impact of COVID-19? (ex. Reducing operating hrs., reducing staff)

Operating Hours

Reducing Staff

Business closed

Other

Based on the business decisions you have made to prepare for the impact of COVID-19, what type of assistance will you need?

Does your business have insurance? Does the policy include business interruption due to COVID-19?

Yes, I have insurance and it includes COVID-19 Policy

Yes, I have insure but it DOES NOT include COVID-19 policy

No, I don't have business insurance

In an effort to promote and stay connected to businesses on Minnesota Avenue, we are requesting that local businesses provide us with all of your social media names and sites. Please list all below (i.e. Twitter - @minnesotaavene, Instagram - @minnesotaave, Facebook - @minnesotaavemainstreet etc...)

Which public and private resources are you planning to access that will assist with business disruption? If the type of assistance you need is not listed above or you would like provide an explanation, please do so here as well.