Pre-Application
Email address *
Name of Business *
Your answer
Business Address *
Your answer
Business and/or Home Phone Number *
Your answer
Applicant('s') Name, Physical Address(es), and Social Security Number(s) *
Your answer
Banking and Credit References (Institution, Contact Name, and Phone Number)
Your answer
Professional References (Names and Phone Numbers)
Your answer
Does this business have any affiliation with or is it a subsidiary of any other company or business?
Do any owners or officers have any outstanding judgments?
Have any owners or officers declared bankruptcy or are any a party to a lawsuit?
Please explain affirmative answers to any of the preceding three questions
Your answer
What is the nature of your business?
Your answer
How much money do you want to borrow?
Your answer
Where would this business be located?
Your answer
How long would it take you to repay the loan (0-15yrs)?
Your answer
To what extent will other monies (including your own) be invested?
Your answer
What will you offer as collateral? What is its value?
Your answer
Will you be willing to sign personally for this loan?
For what purpose would the money for the loan be used?
Your answer
How many permanent full-time nonseasonal jobs will be created as a result of this loan? What wages will you pay? What benefits will you offer?
Your answer
Would you be willing to hire residents of Mitchell, Avery, or Yancey County?
Certification
To the best of my knowledge and belief, data in the application are true and correct. The document has been duly authorized by the governing body of the applicant. MAY Coalition has my permission to check all references, to consult with others regarding this application and to obtain a credit report from Equifax or other sources. The applicant will
comply with the requirements of MAY Coalition if the requested loan is approved, and the applicant agrees that MAY
Coalition is free to use his or her name and image and the company’s name and image for publicity purposes. The applicant
agrees to pay all costs associated with closing of the loan with MAY Coalition (even if the applicant decides after preparation
that he or she no longer wants the loan). (rev.6/18)

By entering my name, title, and date below, I hereby affix my digital signature to this pre-application *
Your answer
*
This application will not be considered before you provide the past two years' tax returns, a personal financial statement, and a business plan.
A copy of your responses will be emailed to the address you provided.
Submit
Never submit passwords through Google Forms.
reCAPTCHA
This form was created inside of MAY Coalition, Inc..