Krafty Qualify Form

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Clone of Krafty Qualify Form

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2
DO YOU HAVE ONE OR MORE COLLECTIONS ON YOUR CREDIT REPORT?* This field is required.
YESNO
3
HAVE YOU EVER BEEN THROUGH ANY TYPE OF CREDIT RESTORATION/ CREDIT REPAIR BEFORE?* This field is required.
YESNO
4
HOW WOULD YOU RATE YOUR CURRENT CREDIT SCORE* This field is required.
Not Good
GREAT
5
HAVE YOU DECLARED CHAPTER 7 BANKRUPTCY IN THE LAST 3 MONTHS?
YESNO
6
HOW MANY CREDIT CARD DO YOU OWN* This field is required.
7
DO YOU KNOW THE DIFFERENCE BETWEEN REVOLVING AND INSTALMENT DEBT?* This field is required.
YESNO
8
HOW MANY TIMES HAS YOUR CREDIT REPORT BEEN PULLED IN THE LAST 6 MONTHS* This field is required.
9
ARE YOU OVER 21* This field is required.Date Of Birth
Month
Day
Year
10
WHO IS THIS FOR?* This field is required.First Name
11
LAST NAME* This field is required.
12
CURRENT STREET ADDRESS* This field is required.
13
CITY* This field is required.
14
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
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virgin Islands
Virginia
Washington
West Virginia
Wisconsin
Wyoming
15
ZIP CODE* This field is required.
16
EMAIL ADDRESS* This field is required.We hate spam so we do not send it.
example@example.com
17
BEST CONTACT INFO* This field is required.Don't Worry, we do not have any pushy sales people that work for us. :)
Area Code
Phone Number
Should be Empty:

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