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Long Island Digital Marketing Agency
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Button Form Test
What type of loan are you interested in?
*
u003ci style=u0022font-size: 50px; padding-bottom: 10px;u0022 class=u0022fa fa-clock-ou0022 aria-hidden=u0022trueu0022u003eu003c/iu003eu003cbr /u003eTerm Loans
u003ci style=u0022font-size: 50px; padding-bottom: 10px;u0022 class=u0022fa fa-banku0022 aria-hidden=u0022trueu0022u003eu003c/iu003eu003cbr /u003eSBA Loans
u003ci style=u0022font-size: 50px; padding-bottom: 10px;u0022 class=u0022fa fa-moneyu0022 aria-hidden=u0022trueu0022u003eu003c/iu003eu003cbr /u003eMerchant Cash Advances
u003ci style=u0022font-size: 50px; padding-bottom: 10px;u0022 class=u0022fa fa-compressu0022 aria-hidden=u0022trueu0022u003eu003c/iu003eu003cbr /u003eConsolidation Loans
u003ci style=u0022font-size: 50px; padding-bottom: 10px;u0022 class=u0022fa fa-credit-cardu0022 aria-hidden=u0022trueu0022u003eu003c/iu003eu003cbr /u003eLine of Credit
u003ci style=u0022font-size: 50px; padding-bottom: 10px;u0022 class=u0022fa fa-dollaru0022 aria-hidden=u0022trueu0022u003eu003c/iu003eu003cbr /u003eWorking Capital
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What type of business is this?
*
Sole Proprietor
LLC
S Corp
C Corp
Partnership
Not Registered
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How much money do you need?
*
$1 – $5k
$5k – $25k
$25k – $50k
$50k – $100k
$100k – $250k
$250k – $500k
$500k – $1M
Over $1M
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What is your business name?
*
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How long have you been in business?
*
Not Yet Started
1 – 6 Months
6 – 12 Months
1 – 2 Years
2 – 5 Years
5+ Years
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What is your monthly gross revenue?
*
No Revenue Yet
$1,000 – $4,999
$5,000 – $9,999
$10,000 – $19,999
$20,000 – $29,999
$30,000+
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What will funds be used for?
*
Select One
Expansion
Purchase Equipment
Purchase A Vehicle
Inventory
Import Goods
Payroll
Marketing
Commercial Real Estate
Remodel My Location
Refinance Debt
Finance Accounts Receivable
Buy A Franchise
Buy A Business
Buyout A Partner
Taxes
Insurance
Working Capital
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What is your credit score?
*
Excellentu003cbr /u003e(720+)
Goodu003cbr /u003e(680 – 719)
Pretty Goodu003cbr /u003e(650 – 679)
Fairu003cbr /u003e(600 – 649)
Oku003cbr /u003e(500 – 599)
Needs Worku003cbr /u003e(499 or below)
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What industry are you in?
*
Select One
Agriculture
Apparel
Banking
Biotechnology
Chemicals
Communications
Construction
Consulting
Education
Electronics
Energy
Engineering
Environmental
Finance
Food u0026 Beverage
Government
Healthcare
Hospitality
Insurance
Machinery
Manufacturing
Media
Not For Profit
Recreation
Retail
Shipping
Technology
Telecommunications
Transportation
Utilities
Real Estate
Other
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What is your personal income?
*
$30,000 or less
$30,000 – $50,000
$50,000 – $75,000
$75,000 – $100,000
$100,000 – $150,000
$150,000+
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Business Zip Code?
*
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What’s your name?
*
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What’s the best way to reach you?
*
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What’s your email address?
*
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