Apply Form – NextGen Funding

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Hybrid Short-Term Loans Application
1. Business Information
Legal Business Name:
DBA Name:
Physical Address:
City:
State:
Business Phone:
Please enter a valid phone number.
ZIP:
Business Fax:
Type of Entity:

2. Hybrid Application
What is credit score?
What industry is your business in?
How long have you been in business?
Do you bank with Chase?

YesNo
Do you bank with Truist?

YesNo
Are you majority owner of the business?

YesNo

3. Hybrid Short Term Loans Questions
Monthly Gross Sales:
Have you ever had a merchant cash advance or do you currently have one open?

YesNo
Amount Requested:
Use of Funds:

4. Partner Information
Partner Name:

First NameLast Name
Partner Email:
example@example.com
Partner Phone:
Please enter a valid phone number.
Should be Empty:

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