First Name
*
Last Name
*
Phone
*
Email
*
Type of Business
*
How long have you been in business?
*
Less than 6 months
6months - 2 years
More than 2 years
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What is your average monthly revenue?
*
Less than $10k
$10k - $20k
More than $20k
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How much funding are you seeking?
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Personal Credit Score
*
Less than 600
600 - 700
Over 700
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Do you have at least 2 credit cards that are 2+ years old and have a minimum credit limit of $2500?
*
Yes
No
Do you have any derogatory remarks on your credit report?
*
Yes
No
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