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Business Loan Form

Page 1

1. Your Contact Information *This question is required.

First Name *This question is required.

Last Name *This question is required.

Company Name *This question is required.

City

State/Province *This question is required.

Country *This question is required.

Email Address *This question is required.

Phone Number *This question is required.

Mobile Phone *This question is required.

URL/Website *This question is required.

2. What search engine, site, list, e-mail or social media initially brought you to Rapid Financial Solutions site? *This question is required.

3. Are you a startup? *This question is required.

4. What does your company do (what industry are you in)? *This question is required.

5. How long has your company been in operation? *This question is required.

6. How much of a loan or advance are you looking for? *This question is required.

7. Do you process at least $5K per month? (for bank loans you need to show at least 4 deposits on your bank statements)

If you are a startup, just state that below *This question is required.

Please enter an 'other' value for this selection.

8. What is your approximate revenue per month?

9. What is your credit score?
*This question is required. We may still be able to help you with poor credit

10. Do you have an open bankruptcy? *This question is required.

11. Do we have your permission to put you on our Free Business Tips List?

We send out one e-mail once every couple of weeks and of course, you can unsubscribe at any time from within the e-mails.

Besides the tips to educate you, this will also keep you up-to-date on any new services we offer that will help your business. *This question is required.

12. Comments