Working Capital Pre-Qualification Form

By completing this form we will be able to pre-qualify your company to get the funds you are looking for.

You agree that Jeanie Marshall may contact you at the phone number(s) and email address provided to discuss unsecured working capital options, answer questions, and assist you in completing the application.

Jeanie will not add you to a mailing list nor give or sell your information to others. 

Items marked with an * are required

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* 1. Business Name, Owners Name, Phone Number, Email Address, Website (if any)

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* 2. How long in business?

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* 3. How much money are you looking for? What will you use the funds for?

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* 4. How much revenue (on average) do you deposit into your Business Bank Account monthly?

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* 5. How many bank deposits do you make (on average) monthly?

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* 6. Does your business have a Merchant Account to accept credit cards?

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* 7. What is your Business Industry?

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* 8. Do you currently have a business loan?

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* 9. What is your business structure?

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* 10. Did someone refer you?  If so, please give us the person's name here:

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