Funding Pre-Qualifier

Contact Information

Contact Name (* required)

Phone (* required)

Email Address (* required)

Company Information

Company Name

Years in Business

Industry (* required)

—Please choose an option—Advertising – MarketingAgricultureApparelArtsAutomotive – SellingAutomotive – ServiceBiotechnologyChemicalsConstructionConsultingDesignEducationEnergyEnergy – GreenEnginneringEntertainmentFilmFood ServiceHealth CareHospitalityInternetManufacturingMediaMedia – Internet BasedNot For ProfitOtherPharmceuticalReal EstateRetail – Bricks & MortarRetail – Internet BasedSoftwareSoftware – Application DevelopmentSportsTechnologyTechnology – Green TechTransporationWholesale

Legal Description of Business

—Please choose an option—Not Yet EstablishedSole ProprietershipPartnershipLLCS-CorporationC-CorporationOther

State/Country Incorporated In

—Please choose an option—AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingInternationalCanada

Website

Business Location

Street Address

City

State

Zip

Business Type

—Please choose an option—Brick & MortarWeb BasedFranchise

Status of Business

—Please choose an option—R&D/ConceptNot Yet OpenedRecently OpenedExpansionAcquisitionMerger

Funding Information

Amount of Funding Needed

—Please choose an option—ApproximateExactUnsure

Seeking

—Please choose an option—DebtEquityEitherCombination

Brief Description of Business (Be concise – Limited to 500 characters) (* required)

Project Overview (Explain how the funding will be used – Limited to 20,000 characters) (* required)

Documents Available For Review

Business Plan

—Please choose an option—Not ApplicableRequest Professional ReviewNeed Professional AssistanceWork in Progress – Will Complete MyselfComplete Investor Ready

Executive Summary

—Please choose an option—Not ApplicableRequest Professional ReviewNeed Professional AssistanceWork in Progress – Will Complete MyselfComplete Investor Ready

Slide Deck

—Please choose an option—Not ApplicableRequest Professional ReviewNeed Professional AssistanceWork in Progress – Will Complete MyselfComplete Investor Ready

Private Placement/Reg D.

—Please choose an option—Not ApplicableRequest Professional ReviewNeed Professional AssistanceWork in Progress – Will Complete MyselfComplete Investor Ready

Other

Financial Documents

3-5 Year Proforma

—Please choose an option—Not ApplicableRequest Professional ReviewNeed Professional AssistanceWork in Progress – Will Complete MyselfComplete Investor Ready

Profit and Loss

—Please choose an option—Not ApplicableRequest Professional ReviewNeed Professional AssistanceWork in Progress – Will Complete MyselfComplete Investor Ready

Balance Sheet

—Please choose an option—Not ApplicableRequest Professional ReviewNeed Professional AssistanceWork in Progress – Will Complete MyselfComplete Investor Ready

Cash Flow Analysis

—Please choose an option—Not ApplicableRequest Professional ReviewNeed Professional AssistanceWork in Progress – Will Complete MyselfComplete Investor Ready

Break Even Analysis

—Please choose an option—Not ApplicableRequest Professional ReviewNeed Professional AssistanceWork in Progress – Will Complete MyselfComplete Investor Ready

Historical Financials

—Please choose an option—Not ApplicableRequest Professional ReviewNeed Professional AssistanceWork in Progress – Will Complete MyselfComplete Investor Ready