State of Maryland Demographic Survey - Restaurant Assistance

State of Maryland Demographic Survey

This form is for gathering statistical data only. The information provided will not be a part of any application approval process. Furnishing this information is voluntary; failure to do so will have no effect on the approval of requested financial assistance.

Question Title

* 1. Business or Organization Name:

Question Title

* 2. I am a

Business Organization

An Individual

A publicly held entity or organization not classifiable as owned by individuals of a particular gender, race, ethnicity or veteran status

I do not wish to furnish this information