Small Businesses Survey

Please complete this survey before registering as a seller. Once submitted, you’ll be redirected to the signup form.

Full Name: Business Name: Business Email:

Business Phone Number:

Share Ownership (%):

Type of Business:

Is your business registered with CIPC?

Yes No

Business Hours per Day:

What is your average monthly revenue?

How old is your business in years?

How many employees do you have?:

Do most/all of your employees work full time or part-time?

On average, how many customers do you receive per-day?

Please enter any active business social media account:

What is the name of your main local supplier?

What makes your business successful? (Select all that apply)

Fast Service High Quality Good Support Good Value Convenient Location

Are you or your business involved in any community projects?

Yes No

What is the name of your community project?

Business Address:

What is your nearest landmark?

Additional Comments:

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