* indicates a required field

*First Name
*Last Name
*Are you a BFCU member?
*Loan Purpose
*Loan Amount
*Business Name
Tax ID Number (if applicable)
SSN (if business is a DBA)
*Is Busines a Start Up?
*Length of Time in Business
*Business Address
*City, State Zip ,
*Business Phone Number
*Business Type
*Number of Employees
*Owner/Principal Name
*Ownership %
*Social Security Number
*Date of Birth
*Home Address
*City, State Zip ,
*Best Contact Number
*Email Address
Select Your Preferred BFCU Location:
* indicates a required field