| FREE PRE-QUALIFYING APPLICATION |
| NAME OF COMPANY |
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| ADDRESS |
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| TELEPHONE NUMBER (AREA CODE) |
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| FAX NUMBER (AREA CODE) |
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| E-MAIL ADDRESS |
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| PERSON / BEST TIME TO CONTACT |
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| DESCRIBE WHAT SERVICE AND/ OR PRODUCT YOUR COMPANY OFFERS |
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| |
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| HOW LONG HAS YOUR COMPANY BEEN IN BUSINESS ? |
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| IF IN BUSINESS LESS THAN 2 YEARS, DO YOU HAVE PAST EXPERIENCE IN YOUR CURRENT FIELD OF WORK? |
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| IF SO, HOW MANY YEARS EXPERIENCE ? |
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| IS THE MAJORITY OWNER (51% OR MORE) A U.S. CITIZEN ? |
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| IF THERE ARE MORE THAN ONE OWNER, WHAT ARE THE PERCENTAGE OF OWNERSHIP FOR EACH OWNER? |
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ARE THE MAJORITY OWNER/OWNERS IN ONE OF THE FOLLOWING GROUPS? |
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| WHAT WAS YOUR GROSS SALES FOR LAST YEAR ? |
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| WHAT ARE YOUR GROSS SALES TO DATE FOR THIS YEAR ? |
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