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Renaissance EDC - Economic Recovery Loan Program
Client's Interest Form
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* Indicates required question
Business Legal Name
*
Your answer
Business Owner's Full Name
*
Your answer
Business Street Address (If home-based, provide home address):
*
Your answer
Business State
*
Your answer
Business City
*
Your answer
Business Zip Code
*
Your answer
Contact Phone #
*
Your answer
Contact Email
*
Your answer
Business Stage (Select One)
*
Startup (less than 1 year)
Less than 2 years
More than 2 years
Required
Business Industry (Select One)
*
Food & Beverage (ie: Restaurant, Cafe, Catering, Bakery, etc)
Personal Service (ie: Nail Salon, Hair Salon, Spa, Dry Cleaning, Laundromat etc)
Retail (ie: Grocery Store, Clothing, Electronics, Furniture, Home Goods etc)
Wholesaler
Manufacturer
Other:
Required
# of Employees
*
Your answer
Main Financing Purpose
*
Startup Costs
Debt Refinancing
Relocation
Renovations
Working Capital
Other:
Required
Loan Amount Needed:
*
Your answer
What language do you prefer to speak? (Select One)
*
English
Mandarin
Cantonese
Korean
Spanish
Required
Ethnicity: (Select One - Optional)
African American
Asian
Caucasian
Latinex
Native American
Other:
How did you hear about Renaissance: (select one - optional)
Bank/Financial Institutions
Empire State Development Corp ( ESDC)
Friends/Family
Library
Newspaper
NYC Department of Small Business Services/Business Solution Centers
Nonprofit/Community Based Organization
Opportunity Finance Network
Radio
Renaissance Digital Newsletter
Small Business Administration (SBA)
Small Business Development Center (SBDC) or SCORE
Small Business Owner
Social Media
Other:
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