Business Funding Intake Form
Full Name
*
Email
*
Credit & Financial Details
How much funding are you looking for?
Under $25,000
$25,000–$50,000
$50,000–$100,000
$100,000+
No elements found. Consider changing the search query.
List is empty.
How soon do you need the funding?
Immediately
30–60 days
60–90 days
Just exploring options
No elements found. Consider changing the search query.
List is empty.
What will the funds be used for?
e.g., startup costs, expansion, debt consolidation, equipment, real estate, emergency, etc.)
What is your approximate personal credit score?
Below 550
550–619
620–679
680–719
720+
No elements found. Consider changing the search query.
List is empty.
Do you have any of the following? (Check all that apply)
Late payments
Collections
Charge-offs
Bankruptcies
None of the above
No elements found. Consider changing the search query.
List is empty.
Let's Talk About Your Business
Is your business legally registered?
Yes
No
In progress
No elements found. Consider changing the search query.
List is empty.
How long has your business been operating?
Not launched yet
0–6 months
6–12 months
1+ year
No elements found. Consider changing the search query.
List is empty.
Average monthly business revenue (if any):
$0
Under $10,000
$10,000–$25,000
$25,000+
No elements found. Consider changing the search query.
List is empty.
Do you currently have business credit established?
Yes
No
Not sure
No elements found. Consider changing the search query.
List is empty.
Have you applied for funding before?
Yes – approved
Yes – denied
No
No elements found. Consider changing the search query.
List is empty.
Are you open to credit optimization if needed to qualify?
Yes
No
Need more info
No elements found. Consider changing the search query.
List is empty.
What’s your biggest concern about getting funding right now?
Are you ready to move forward within the next 30–60 days if approved?
Yes
No
Just gathering information
No elements found. Consider changing the search query.
List is empty.
SUBMIT