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Intake form
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Name
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Email address
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What type of funding are you interested in?
Please select at least one option.
Equipment Financing
Working Capital Loans
Business Lines of Credit
Startup & Expansion Capital
What is the purpose of the funding?
Please select at least one option.
Payroll
Inventory
Marketing
Emergency Expenses
Equipment Purchase
Business Expansion
What is your business structure?
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Sole Proprietorship
Partnership
Corporation
Limited Liability Company (LLC)
Non-Profit
How long has your business been operating?
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Less than 1 year
1-3 years
3-5 years
5-10 years
More than 10 years
What is your estimated annual revenue?
Select
Less than $50,000
$50,000 - $100,000
$100,000 - $250,000
$250,000 - $500,000
More than $500,000
What is your primary industry?
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Retail
Hospitality
Construction
Healthcare
Technology
Manufacturing
Which service or services are you interested in?
Please select at least one option.
Equipment financing
Working capital loans
Business lines of credit
Business credit
Additional questions or comments
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