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Business Funding Assessment Form

Tell Us About Your Business
Answer the questions below, and we’ll get started on your funding proposal. No commitments, just clear options tailored to your needs.

Click the button below to start.

Start

Section 1: Personal Information

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Question 2 of 22

First name:

Question 3 of 22

Surname:

Question 4 of 22

Business Name:

Question 5 of 22

Contact Number:

Question 6 of 22

Email Address: 

Question 7 of 22

Location (City/State/Country):

Section 2: Business Details

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Question 9 of 22

What type of business do you own?

Question 10 of 22

How long have you been in business?

A

Less than 1 year

B

1-3 years

C

Over 3 years

Question 11 of 22

What is your average monthly revenue?

A

Under $10K

B

$10K-$50K

C

Over $50K

Question 12 of 22

Do you have a business bank account?

A

Yes

B

No

Question 13 of 22

Outstanding Business Financing (Loans/Credit Lines)?
Enter amount or type “None”.

Section 3: Credit & Financial History

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Question 15 of 22

What is your current personal credit score range?

A

Below 550

B

550-650

C

650-750

D

Above 750

Question 16 of 22

Have you had any bankruptcies or collections in the past 3 years?

A

Yes

B

No

Question 17 of 22

Do you currently have business credit established?

A

Yes

B

No

Section 4: Funding Needs

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Question 19 of 22

How much funding are you looking for?

A

Under $50K

B

$50K-$100K

C

$100K-$150K

D

$150K-$200K

E

Over $250K

Question 20 of 22

What do you plan to use the funding for?

A

Inventory

B

Expansion

C

Marketing

D

Hiring Staff

E

Other

Question 21 of 22

How quickly do you need the funds?

A

Within a week

B

Within a month

C

Flexible

What Happens Next?

 

  • Once submitted, we will review your assessment and check your eligibility.
  • If you qualify, you’ll receive a proposal with funding options, or we’ll reach out for more details.
  • No commitments – You stay in control.

Confirm and Submit