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2. First Name
3. Last Name
5. Phone Number
6. Email Address
8. Business Name
10. Business Address
12. Business Website
14. Business Type
    -- Select One --RetailRestaurantHealthcareTransportationManufacturingConstructionFinance & InsuranceEducational ServicesProfessional ServicesBeauty Salons / Barber ShopsOther
16. Number of employees (counting yourself)
    -- Select One --12 - 56 - 1011 - 3030+
18. Business Registration (check all that apply)

    1. State of Florida (Sunbiz)
    2. Broward County (Broward Tax Receipt)
    3. City Of Lauderdale Lakes Business Tax Receipt
20. Relationship with the City Of Lauderdale Lakes
    -- Select One --Lauderdale Lakes ResidentLauderdale Lakes For-profit businessLauderdale Lakes nonprofit businessOther
22. Number of years in business
    -- Select One --0 - 1234 - 55+
24. Sales in 2022
    -- Select One --$0 - $49,000.00$50,0000 - $099,000$100,000 - $125,000$126,000 - $200,000$201,000 - $500,000$501,000 - $999,999$1 Million +
26. Tell us about your business. Be sure to include information about the product and service that you offer and who your customers are:
28. How do you currently market your business?
30. What are the top 3 challenges facing your business?
32. What are your top 3 business goals for 2023?
34. Check all of the following marketing tools that you currently have set up for your business:

    1. Website
    2. Facebook
    3. Instagram
    4. Twitter
    5. TicTok
    6. YouTube
    7. Linkedin
    8. Flyer / Brochure
    9. Retractable Banner
    10. Signage
    11. Business Cards
36. Please provide links to all your social media handles:
38. Upload your logo here:*
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40. 1. Receive an email copy of this form.
41. Email address

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42. Submit

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