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LISC LA Kiva Borrower Intake Form

Kiva is an online loan crowdfunding platform that enables entrepreneurs to access 0% interest small business loans up to $15,000. LISC LA has a Kiva Accelerator Fund to match borrower campaigns $1 for $1. In order to receive the matching funds, businesses need to be endorsed by a LISC Kiva Trustee in LA County. Kiva’s model is unique because it uses social underwriting--a borrower’s character, relationships, and reputation--instead of their credit scores or assets to access business capital.

Please complete the intake form to start the process and be eligible for the Kiva Accelerator Fund match.
1.First Name(Required.)
2.Last Name(Required.)
3.Email Address(Required.)
4.Business Name(Required.)
5.Business Address(Required.)
6.Business City/Town(Required.)
7.Business State(Required.)
8.Business Zip Code(Required.)
9.Website(Required.)
10.Primary Social Media Address (e.g. Facebook, Twitter, or Instagram)(Required.)
11.Years in Operation(Required.)
12.What was your business’s gross revenue in the calendar year 2019 (1/1/2019 to 12/31/2019)?(Required.)
13.What was your business’s gross revenue in the calendar year 2020 (1/1/2020 to 12/31/2020)?(Required.)
14.Do you have a business license?(Required.)
15.Business Industry(Required.)
16.Gender(Required.)
17.Veteran(Required.)
18.Race/Ethnicity(Required.)
19.How did you hear about the LISC LA Kiva Program?(Required.)
20.Have you worked with a Kiva Trustee?(Required.)
21.What size loan are you interested in for your business? Note: The maximum Kiva loan size is $15,000(Required.)
22.How will you use the Kiva loan for your business?(Required.)
23.LISC LA has a number of partners and programs to assist small businesses. Which of the following areas your business is interested in learning more about? Please check all that apply.(Required.)
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