Credit Building Nation Application
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Name *
Email *
State of Residency *
Phone number *
Business Name *
Business Website Address
Average Monthly Revenue *
Average Monthly Profit *
Are you employed outside of your business? *
Other Monthly Income *
Monthly Rent or Mortgage Payment *
Number of active/open credit card *
Total credit credit card limit *
Total credit card outstanding balance *
How many times have you been late on making your credit card monthly payments in the past 12 months? *
Have you been denied credit in the past 12 months? yes/no *
Current Credit Score (i.e. From Credit Karma) *
Do you want information for improving your credit score? *
Do you have a checking or savings account? *
What is the total balance of any checking and saving accounts? *
Have you filed bankruptcy in the past 2 years (e.g. Chapter 7, Chapter 13)? *
Do you plan to file bankruptcy in the next 2 years? *
Are you currently in a correctional institution? *
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