Wufoo

Loan Pre-Application

Date * / MM / DD YYYY
I. General Information
Name of Organization *
Location (City, State) *
Web Site
Founded/Incorporated *
Type of Corporation *
Primary Activity or Social Mission *
II. Primary Contact Information
Primary Contact * First Last
Title *
Email Address *
Phone * - (###) - ### ####
III. General Project Description
Loan Amount Requested *
Purpose *
Do you own your own building? Yes No
In a few sentences, please describe how the loan proceeds will be used: *
Please also describe other significant project costs and how they will be paid: *
From what sources will you repay the loan? *
What are the timing considerations for this loan request? *
How did you hear about us? *
Other Comments
Do Not Fill This Out