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Home / Coaching / Business Loan Broker Service / Application Form

Business Loan Application Form

First Name *

Last Name *

Email *

Phone *

What is your business name?

What is your website?

Type of Business Entity

Limited Liability Company (LLC)

Sole Proprietorship

Partnership

Corporation (C-Corp or S-Corp)

Non-Profit

How long have you been in business?

Less than 1 year

1-3 years

3-5 years

More than 5 years

What is the primary reason you are seeking business funding?

Working Capital

Equipment Purchase

Expansion

Marketing/ Advertising

Inventory Purchase

Debt Consolidation

Other

How much funding do you need?

How soon do you need the funding?

Right Away

1-2 weeks

2-4 weeks

4-8 weeks

16 weeks

What is your business monthly cash flow?

Negative

Break-even

Less than $10,000

$10,000 - $50,000

$50,000 or more

How much business debt do you have?

What is your personal credit score?

Below 600

600-649

650-699

700-749

750 and above

To confirm, you are filling this out because you want to learn more about us helping you get funding for your business, business idea, or real estate investment even with bad credit.

Yes I am seriours and want to learn more about getting funding for my business.

Yes I am very interested in getting funding for my business but don't need a lot of help

No, I am going to leave this page immediately.

What makes you interested in our proprietary funding framework to help you get capital for your business? Why is it compelling compared to other opportunities or other ways of acquiring funding on your own or with other companies (select all that apply)?

Because i can use your system to implement it right away in order to acquire capital

I want to stop guessing and randomly applying for funding that ends up getting denied even though i thought i qualify for it

Compared to taking a course or working with other "gurus" that have never worked in the industry, I can work with a former bank Vice President and business loan broker without charging outrageous fees.

I want to have the best chance of getting approved and getting access to the right lenders for my business.

Which of the options below best describes your goal with getting funding for your business?

I want to get funding for my brand new business

I own a revenue generating business already and need funds for a project

I have bad credit and own a business and need quick access to capital

I don't have a business and need start up funding

I am tired of getting declined and need help to grow my business

If we were able to find a way to get you funding based on your current situation, Would you be willing and able to invest in getting the help necessary to get there?

Yes I have the cashflow to invest in myself

Yes I may or may not have the cashflow but i'm resourceful and/or have access to credit

No, my cashflow is month to month and i have no access to credit but i'm willing to get financing to join this program.

No, I don't like to invest in myself.

What's happening in your life/business right now that has you seeking capital? Be Very detailed.

Do you have a significant other or business partner that needs to be on the call? If so will they be able to attend the call?

We respect your time and we'd like to believe you're a person of integrity who respects ours. Are you going to show up for the call on time and date selected?

Yes I will stay 100% committed to the time I choose

Maybe, I'm not sure if I'm serious about this.

Did you watch the full video? The video explains the program so it gives us enough time to just talk about your business and see if we can help. We might reschedule the call if you haven't seen the full video.

Yes

Send text messages to

Anything else we should know?

The Multifaceted Mama was founded with one goal in mind... to celebrate our ability to show up authentically in the spaces and places that we operate in each day!

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