Contact Information

* Full Name:

* Company:

* Address:

* City:

* State:

* Zipcode:

* Home Phone:

Mobile Phone:

Fax Number:

* Email:

Demographics

* County Resident:

Choose One Yes No

* Referral Source:

* Type of Business:

Choose One LLC Sole Corp.

Business Information

* Number of Employees:

Choose One 1-5 6-10 11-20 >20

* Annual Sales:

Choose One < $100,000 $100,000 - $250,000 $250,000 - $500,000 > $500,000

* Years of Operating History:

Choose One < 1 2 - 4 5 - 7 > 7

* Industry:

* Experience in the Industry:

Choose One Yes No

* Phase of Business:

Choose One Expansion Retention Start-Up Franchise

Loan Request

Program you are interested in:

Choose One SBA 504 Fixed Asset/Commercial Real Estate Financing Asset Based Lending Program (Accounts Receivable Funding) Small Business Growth Fund Contractor Cash Flow Fund New Market Tax Credit Program Bowie Revolving Loan Fund

* Total Project Cost:

* Loan Amount:

* What will the loan proceeds be used for?

* How much equity have you invested in the business?

Choose One < $100,000 $100,000 - $250,000 $250,000 - $500,000 > $500,000

* Type of Equity:

Choose One Cash Equipment Property

* Do you have a Business Plan?

Choose One Yes No