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Loan Contact Form
Loan Contact Form
First Name
*
Last Name
*
Email
*
Phone Number
*
Location of Business
*
Business Name
*
Number of Employees
Please Select
N/A
1-4
5-9
10-19
20-29
30-39
40-49
50+
Business Industry:
Please Select
Retail
Food + Hospitality
Manufacturing
Agri-food + Food Processing
Creative Industries
Social Enterprise
Construction + Trades
Other
Business Industry:
How long have you been in business?
Please Select
Exploring entrepreneurship – I have not started my business yet
Startup – In business less than two years
Existing business – In business two years or more
What do you require financing for?
Start-up
Expansion
Working Capital
Leasehold + Building Improvements
Equipment Purchases
Training
Innovation + Technology
How much financing are you looking to secure?
$2,500 - $14,999
$15,000 - $24,999
$25,000 - $49,999
$50,000 - $99,999
$100,000 - $199,999
$200,000 - $299,999
$300,000+
Use this area to provide us with more information:
How did you hear about us?
Please Select
An event (e.g. seminar, workshop, tradeshow)
Referral from Chamber of Commerce
Referral from Small Business Advisory Centre
Referral from government service
Referral from municipality
Web search
Word of mouth
Social media
Other
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