HORIZON GLOBAL BUSINESS FUNDING Funding Readiness Assessment

1
First Name* This field is required.
2
Last Name* This field is required.
3
Email Address* This field is required.
example@example.com
4
Mobile Phone Number* This field is required.
Please enter a valid phone number.
5
City* This field is required.
6
State* This field is required.
Please Select
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
7
How did you hear about Horizon Global Business Funding?* This field is required.
Please Select
Please Select
Kingdom Chamber of Commerce
Secret Sauce
Referral
Social Media
Webinar or Event
Google/Search
Horizon Global Website
Other
8
Legal Business Name* This field is required.
9
Business Website
10
Business Structure* This field is required.
Please Select
Please Select
LLC
S Corporation
C Corporation
Partnership
Sole Proprietorship
Nonprofit
Other
11
State Registered In* This field is required.
12
Industry* This field is required.
13
Time in Business* This field is required.
Please Select
Please Select
Not yet operating
Less than 6 months
6–12 months
1–2 years
2–5 years
5–10 years
10+ years
14
Does your business have an Employer Identification Number (EIN)?* This field is required.
Please Select
Please Select
Yes
No
Not sure
15
Dedicated business bank account established?* This field is required.
Yes
No
16
Business physical or professional address* This field is required.
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
17
Dedicated business phone number* This field is required.
Please enter a valid phone number.
18
Are all required business licenses and registrations current?* This field is required.
Yes
No
Not sure
19
Approximate annual business revenue* This field is required.
Pre-Revenue
Under $25,000
$25,000–$49,999
$50,000–$99,999
$100,000–$249,999
$250,000–$499,999
$500,000–$999,999
$1 Million+
20
Average monthly business revenue* This field is required.
Pre-Revenue
Under $5,000
$5,000–$9,999
$10,000–$24,999
$25,000–$49,999
$50,000–$99,999
$100,000+
21
Revenue consistency over the last 6 months* This field is required.
Please Select
Please Select
Very consistent
Mostly consistent
Some fluctuations
Highly variable
Too early to tell
22
Are tax filings current?* This field is required.
Yes
No
In process
Not sure
23
Business credit profile* This field is required.
Please Select
Please Select
Established
Limited
None
Not sure
24
Reviewed business credit reports recently?* This field is required.
Yes
No
Not sure
25
Is payment history reporting to business credit bureaus?* This field is required.
Yes
No
Not sure
26
Number of reporting business trade accounts* This field is required.
Please Select
Please Select
None
1–3
4–6
7–9
10+
Not sure
27
Personal credit and guarantee note
28
Approximate personal credit score range* This field is required.
750+
700–749
680–699
650–679
600–649
Below 600
Not Sure
Prefer to discuss privately
29
Credit events during the last 24 months
Late Payments
Collections
Charge-Offs
High Credit Utilization
Bankruptcy
None of the Above
Prefer to Discuss Privately
30
How much business capital are you seeking?* This field is required.
Under $10,000
$10,000–$24,999
$25,000–$49,999
$50,000–$99,999
$100,000–$249,999
$250,000–$499,999
$500,000+
I'm Not Sure Yet
31
What will you use the capital for?* This field is required.
Working Capital
Marketing
Payroll
Inventory
Equipment
Real Estate
Expansion
Hiring
Debt Refinancing
Business Acquisition
New Location
Contract/Project Fulfillment
Other
32
Have you applied for business funding during the last 12 months?* This field is required.
Yes
No
33
What was the result?
Please Select
Please Select
Approved for the amount requested
Approved for less than requested
Approved but did not accept the terms
Declined
Multiple declines
Application pending
Other
34
If you were declined, do you know why?
Please Select
Please Select
Yes
No
I received reasons but don't fully understand them
Not Applicable
35
Approximately how many business funding applications have you submitted during the last 6 months?
Please Select
Please Select
1
2–3
4–5
6+
Not Sure
36
Note
37
What is your biggest challenge when it comes to obtaining business funding?* This field is required.
38
If you had access to the right capital, what would it allow your business to accomplish?* This field is required.
Should be Empty: