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