Business Capital Prequalification Form

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By completing this form we will be able to pre-qualify your company's ability to get the funds you are looking for. Note: These are not SBA Emergency or PPP loans.

You agree that we can then contact you at the phone number(s) and email address provided to discuss funding options, answer questions, and complete the application. If you provide your mobile number, this contact may include text messaging. Providing a mobile number is not a condition of this funding.

How Much Money Would You Like? *

Current Monthly Sales? *

Less Than $10,000 (Only Qualifies For Micro-Funding)

$10,000-$20,000

$20,000-30,000

$30,000-$50,000

$50,000-$75,000

$75,000-$100,000

$100,000-$250,000

$250,000-$500,000

$500,000-$1,000,000

$1,000,000+

How Long Have You Been In Business? *

Less Than 4 Months (Does Not Qualify For Funding)

4 Months - 1 Year

1 Year - 3 Years

3 Years - 5 Years

5 Years - 10 Years

10+ Years

Number of Deposits From Sales Per Month? *

Under 3 (Does Not Qualify For Funding)

3 - 10 Deposits

10 - 20 Deposits

20+ Deposits

Number of Days Your Bank Account Negative This Month? *

None

Under 3

Over 3 (Does Not Qualify For Funding)

Company Name *

Nature of Business? *

State Company Located In? *

Owner's Name? *

Owner's Email Address? *

Owner's Office Number? *

Owner's Mobile Number?

Approximate FICO Credit Score Of Owner? *

Name of Bridgepoint Agent Who Referred You? *

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