The pre-qualification questions must be answered upon filling out the financing application for eligibility purposes.Name* First Last Email* Phone*Are you 18 years of age or older?*YesNoIs your business located in one of the following counties in Pennsylvania: Bedford, Blair, Cambria, Fulton, Huntingdon, Indiana, Somerset?*YesNoAre you a citizen of the US or have legal status?*YesNoHave you had a bankruptcy in the last 18 months?*YesNoDo you have any past due child support payments?*YesNoIs your business engaged in adult entertainment or on-line gambling?*YesNoAuthorizationEverything I/we have stated in the pre-qualification is correct to the best of my/our knowledge.CommentsThis field is for validation purposes and should be left unchanged.