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Funding Assessment Form

Full Name

*

Email Address

*

Phone Number

*

What is your current personal credit score?

*

What is your current personal credit score?

A

Below 600

B

600-679

C

680+

How much funding are you looking to secure?

*

How much funding are you looking to secure?

A

Under $10,000

B

$10,000-$50,000

C

$50,000+

Do you currently have a registered business (LLC, Corp, etc.)?

*

Do you currently have a registered business (LLC, Corp, etc.)?

A

Yes

B

No

Do you have a business bank account?

*

Do you have a business bank account?

A

Yes

B

No

Do you have an EIN (Employer Identification Number)?

*

Do you have an EIN (Employer Identification Number)?

A

Yes

B

No

What is your estimated monthly business revenue?

*

What is your estimated monthly business revenue?

A

Less than $5,000

B

$5,000 – $15,000

C

$15,000+

What do you plan to use the funding for?

*

What do you plan to use the funding for?

A

Working capital

B

Marketing/advertising

C

Equipment

D

Inventory

E

Business startup

F

Personal reasons

G

Other

When are you hoping to secure funding?

*

When are you hoping to secure funding?

A

Within 7 days

B

Within 30 days

Are you ready to invest in funding prep services if you qualify?

*

Are you ready to invest in funding prep services if you qualify?

A

Yes — I'm ready to invest in my business

B

Maybe — I need more info

C

No — I'm not in position to invest right now