Business Financing Form

Make sure you:
  1. Include an email address. You cannot send this form if you do not include a valid email address. LET ME STATE THAT AGAIN! We need a valid email address. (Need an email account? Sign up here.)

  2. Tell us something about your business. Fill out and return the business plan outline here. (Click here.) Download or right click on this link and save file. NOTE:  Save file under a different name and return (via email) to us. Want to send us a hard copy form? Fax to 866-867-3795.

Name:

Company:

Phone:

Fax:

E-Mail:

Address:

City:

State/Zip:
  
Info 1:

Info 2:


Business Ownership: Select to indicate one of the following groups:
Asian
Black
Hispanic
Native American
Women
More than one category

How long have you been in business?
Start up
One to five years
Five to ten tears
Over ten years

Type of assistance required:
Bank Loan or other financing
Business Plan/Planning
Other

Timeframe for assistance:


Description of business/project:


Additional Description or Comments (be sure to include any relevant web sites):


The fine print: By submitting this form, you certify as follows:

That all of the above information is true and correct to the best of my knowledge and belief. I attest that I am not affiliated with a competitor to Creative Investment Research, Inc., or a past employer of any person currently employed by Creative Investment Research, Inc. I am seeking to finance a legitimate business, and I am not seeking to finance or participate in any fraudulent acts or activities. I hereby authorize the release to Creative Investment Research, Inc. of all credit history and information required for the purpose of processing and evaluating the applicant's credit transaction. The undersigned also permits Creative Investment Research, Inc. to release the applicant’s form information and otherwise exchange information regarding applicant’s credit transaction to various business professionals involved in the transaction, including but not limited to agents, accountants, attorneys, the U.S. Small Business Administration, and third party financial institutions.