Client Intake Form
KO Enterprise Group
Name
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Email
example@example.com
Best time to contact you?
Morning
Afternoon
Evening
Preferred method of contact
Phone Call
Email
Text Message
Service Requesting
Personal Credit Repair
Grant
Medical Transportation
Do you currently have credit montoring?
Yes
No
Credit Score Range
300-499
500-599
600-649
650-699
700+
đ Please upload a screenshot of your current Credit Factors page from Credit Karma.
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Do you currently own a business?
Yes
No
If yes, what's your business name and structure (LLC, Sole Proprietorship, Corporation, ect)
Funding Goals
up to 50k
up to 80k
up to 100k
Do you have an EIN?
Do you have a business banking account?
Time in Business
Primary purpose for funding?
Are you ready to invest in your credit, funding, and or passive income opportunity?
Yes, I'm ready!
I have a few questions first
Not yet just exploring
How did you hear about us?
Social Media
Referral
Google
Other
If referred, who referred you?
Signature
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Continue
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