Saint Peters Preparatory School Microbank

Micro Loan Application

Applicant Information
Name __________________________________________
Date of Birth ____________
Business Name ___________________________________
Business Address
Home Phone Business Phone
E-Mail Address
How many adults do you support
How many children do you support
!an you read and write En"lish
#hat other lan"ua"es can you spea$% read and write
Are you a &eteran
#hat le'el of education ha'e you completed
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Housin" (tatus) *ent +wn Pu,lic
Business Information
*e'enue Last -uarter
Profit Last -uarter
Business De,t Last -uarter
Does the ,usiness ha'e a ,an$ account Name the ,an$.
Please attach the last /uarterly statement.
Has the ,usiness recei'ed any loans If so% pro'ide the name of
the lender and indicate the status of the loan.
Are there any claims or lawsuits a"ainst your ,usiness or you
personally If so% e0plain.
Ha'e you or the ,usiness e'er declared ,an$ruptcy If so%
when
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Are there any state or federal ta0 liens filed a"ainst the
,usiness or you personally
Business History 12ell us how% when% where and why the
,usiness started. Descri,e the ,i""est challen"e the ,usiness
faces. Descri,e the customers and community that the ,usiness
ser'es #hat in the ,usiness are you most proud of3
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+'er'iew of Proposal for Loan 1Descri,e how the loan ser'es
your ,usiness and community3
#hat is the amount of the loan that you see$
#hich repayment schedule are you see$in"4
+ne year
2wo years
2hree years
4*epayment ,e"ins after the first full /uarter followin" the
administration of the loan.
Descri,e how the mission of your ,usiness is li$e the mission of
this micro,an$.
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How will this loan "row your ,usiness% increase re'enue and
profit
List the names% addresses% and contact information for three
school% ,usiness% or community references 1please do not use
family mem,ers or friends3
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A"reements
Prep Micro,an$ A"ent 15aculty Mem,er of (aint Peter6s Preparatory (chool3
_________________________________ __________________
Name Date
_________________________________ __________________
#itness Date
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%& ''''''''''''''''''''''''''& a!ree that all the infor(ation pro)i*e* by
the loan applicant is an accurate an* le!al representation of the or!ani+ation an*
finances of the business that he/she represents, % a!ree that any
(isrepresentation of the business or its a!ents ren*ers this application )oi*,
''''''''''''''''''''''''''''''''''''' '''''''''''''''''
-a(e .ate