Business Grant Impact Survey Form
Share how your grant supported your business and community.
Organization name
*
Respondent name
*
Respondent role/title
*
Respondent email
*
example@example.com
Grant program or award name
*
Grant amount received
*
How the grant funds were used
*
Rate the grant’s contribution to each area
*
Rows
No contribution
Small contribution
Moderate contribution
Significant contribution
Very significant contribution
Business growth
1
2
3
4
5
Operational capacity
6
7
8
9
10
Community impact
11
12
13
14
15
Jobs created or retained because of the grant
*
Overall impact and remaining needs
*
Submit survey
Should be Empty: