New Hampshire Community Loan Fund inquiry form

About you

First name:

Last name:

Preferred phone:

Phone:

Preferred email:

Email:

About the organization

Company name:

Website:

Primary product or service you provide:

Address

Street address:

City:

State:

Zip code:

For-profit or nonprofit?

Date established:

About your financing need

How did you hear about us?

If an individual or organization referred you to us, please specify:

Description of financing need:

Anticipated amount needed from the Community Loan Fund:

Please enter dollar amount without commas

Total financing need, including other sources:

Please enter dollar amount without commas

Are you interested in technical assistance

Yes
No
Technical assistance includes a variety of coaching, education, and support opportunities tailored to business needs.

Technical assistance area of interest

Questions or comments:

Staff use only

Name of Relationship Manger