Apply Save my progress and resume later | Resume a previously saved form Resume Later In order to be able to resume this form later, please enter your email and choose a password. Your Email: A Password: Confirm Password: Password must contain the following: 12 Characters 1 Uppercase letter 1 Lowercase letter 1 Number 1 Special character Loan Application: Basic Info Applicant Contact Info First Name Last Name Title Email Address Phone Basic Business Info Business Name Website What is the legal structure of your business?Please select... Cooperative LLC Corporation Sole Proprietorship Partnership Nonprofit Other Other (please describe) What type of cooperative?Please select... Food Coop Employee-Owned Business Housing Coop Purchasing Coop Consumer Coop (non-food) Other Other (please describe) Business Location Street Address City StatePlease select... AL AK AZ AR AS CA CO CT DE DC FL GA GU HI ID IL IN IA KS KY LA ME MH MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH MP OK OR PW PA PR RI SC SD TN TX UT VT VA VI WA WV WI WY Postal Code Mailing Address (if different) Street Address City StatePlease select... AL AK AZ AR AS CA CO CT DE DC FL GA GU HI ID IL IN IA KS KY LA ME MH MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH MP OK OR PW PA PR RI SC SD TN TX UT VT VA VI WA WV WI WY Postal Code Loan Application: Business Details Business Financials Please upload business financial statements (balance sheet, profit & loss, and cash flow statement) for at least the past 3 years, as well as year-to-date financials for the current year. For newer businesses please upload as much data as is available. Fiscal Year Upload files here Please upload an operating pro forma (financial projections) for at least the next 3 years: Please ensure your pro forma covers at least the period of your desired loan term (if greater than 3 years) Please upload business bank statements for the 3 most recent months: Bank Statement 1: Bank Statement 2: Bank Statement 3: Business Management In which month does your fiscal year end?Please select... January February March April May June July August September October November December What year was your business founded? Please upload your business plan: Please list key management personnel below: Name Title Resume or brief bio Loan Application: Loan & Project Details Desired Loan Amount Please do not include a dollar sign $ in front of the value. x What is the purpose of this loan? (check all that apply)StartupExpansionWorking CapitalBusiness AcquisitionMachinery and EquipmentReal EstateCo-op ConversionOther Please provide a brief description of the project and financing needs. Sources and Uses of Funds Please list all capital sources, including owner's equity, as well as each major use in the project budget. Source Amount Use Amount Please provide any additional information that would help us evaluate your loan application. Please attach any other relevant documents you'd like to include (e.g. lease, contractor estimates, etc) How did you hear about LEAF?Please select... Advertisement Web Search Word of mouth Press Social Media Other Prefer not to answer Other (please describe) Employee Details Please indicate if 50% or more of your members reflect any of the following ethnicities (check all that apply).WhiteBlack or African AmericanAmerican IndianHispanicAsianNative HawaiianAlaska NativeOther Pacific IslanderMiddle Eastern or North AfricanOther Other Please indicate if 50% or more of your members reflect any of the following demographics (check all that apply).Women ImmigrantsUS Military VeteransLGBTQ+ Do any of your owners face the following obstacles to employment? Check all that apply.Previous IncarcerationHomelessnessSubstance AbuseDisabilityOther Current Number of Members Entry Level Wage (Hourly) Please do not include a dollar sign $ in front of the value. x Amount of Local Food Purchased by Food Coop ($) Please do not include a dollar sign $ in front of the value. x How many full-time (35+ hours/ week) employees does your business currently have? How many part-time ( less than 35 hours/ week) employees does your business currently have? Employee Details Please indicate if any of your owners reflect the following ethnicities (check all that apply).WhiteBlack or African AmericanAmerican Indian HispanicAsianNative HawaiianAlaska NativeOther Pacific IslanderMiddle Eastern or North AfricanOther Other Please indicate if any of your owners reflect the following demographics (check all that apply).Women ImmigrantsUS Military VeteransLGBTQ+ Do any of your owners face the following obstacles to employment? Check all that apply.Previous IncarcerationHomelessnessSubstance AbuseDisabilityOther Entry Level Wage (Hourly) Please do not include a dollar sign $ in front of the value. x How many full-time (35+ hours/ week) employees does your business currently have? How many part-time ( less than 35 hours/ week) employees does your business currently have? Employee Details Please indicate if 50% or more of your members reflect any of the following ethnicities (check all that apply).WhiteBlack or African AmericanAmerican IndianHispanicAsianNative HawaiianAlaska NativeOther Pacific IslanderMiddle Eastern or North AfricanOther Other Please indicate if 50% or more of your members reflect any of the following demographics (check all that apply).Women ImmigrantsUS Military VeteransLGBTQ+ Do any of your owners face the following obstacles to employment? Check all that apply.Previous IncarcerationHomelessnessSubstance AbuseDisabilityOther Entry Level Wage (Hourly) Please do not include a dollar sign $ in front of the value. x Current Number of Worker-Owners How many full-time (35+ hours/ week) employees does your business currently have? How many part-time ( less than 35 hours/ week) employees does your business currently have? Housing Details Current Number of Households in the Housing Cooperative Total Number of Residents Number of Immigrant Residents Number of Female Residents Median Rent Please do not include dollar signs. x Please indicate if any of your tenants reflect the following ethnicities (check all that apply).WhiteBlack or African AmericanAmerican IndianHispanicAsianNative HawaiianAlaska NativeOther Pacific IslanderMiddle Eastern or North AfricanOther Other Please indicate if any of your tenants reflect the following demographics (check all that apply).Women ImmigrantsUS Military VeteransLGBTQ+ Confidentiality PolicyI have read and agree to LEAF's terms and confidentiality policy LEAF is an equal opportunity provider, employer, and lender. Save my progress and resume later | Resume a previously saved form Contact Information