| State where your business is located: * |
|
| Business Name * |
|
| Your First Name: * |
|
| Your Last Name: * |
|
| Address 1: * |
|
| Address 2: |
|
| City: * |
|
| State: * |
|
| Zip Code: * |
|
| Day Time Phone: * |
|
| Fax: * |
|
| E-mail: * |
|
| Your position in the business: * |
|
| What industry are you currently in? * |
|
| How long has your company been in business? * |
|
| How many years of experience do you personally have in this business or industry? * |
|
| How many employees do you have? * |
|
| Does the business rent or own the building in which it will operate? * |
|
| What are your annual sales? * |
|
| What is the loan amount you want? * |
|
| What will the loan be used for? * |
|
| Select one or more purposes: * |
|
| If "other," please describe: |
|
| Have any of the owners been arrested or convicted of any criminal offense other than a minor traffic violation in the last ten years? * |
|
|
If "Yes," please describe:
|
| How did you learn about WPI Financial Services? * |
|
| If "Other," please describe: |
|
| Referring Company: |
|
| Referring Associate: |
|
|
Tell us more about your business in the following section:
|
| After you have completed the questionnaire, press the "Submit" button. |
