Today's Date

MM

DD

YYYY

Application

NEW APPLICATION

RESUBMISSION

APPLICANT INFORMATION

Please Choose

CHURCH

SCHOOL

DENOMINATIONAL OFFICE/MINISTRY

AFFILIATED MINISTRY

Name *

First Name

Last Name

MINISTRY PHONE

(###)

###

####

MAILING ADDRESS

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

YEAR FOUNDED

MM

DD

YYYY

IS MINISTRY INCORPORATED?

Yes

No

DATE OF INCORPORATION

MM

DD

YYYY

MINISTRY FAX

(###)

###

####

LEAD PASTOR or MINISTRY HEAD

First Name

Last Name

START DATE

MM

DD

YYYY

OFFICE PHONE

(###)

###

####

MOBILE PHONE

(###)

###

####

CHURCH TREASURER or ADMINISTRATOR

First Name

Last Name

OFFICE PHONE

(###)

###

####

MOBILE PHONE

(###)

###

####

DATE NEEDED

MM

DD

YYYY

TYPE OF LOAN

Mortgage

Unsecured Note

PURPOSE OF LOAN

Purchase

Refinance

Renovation

Other:

WILL ADDITIONAL FUNDS BE NEEDED BEYOND THE AMOUNT REQUESTED?

Yes

No

IS THERE, OR WILL THERE BE A CAPITAL CAMPAIGN FOR THIS PROJECT?

Yes

No

ADDRESS OF PROPERTY TO BE USED AS COLLATERAL

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

THIS PROPERTY IS:

Currently owned by the Borrower

Being purchased with this financing

AND IS:

Improved Property

Vacant / Unimproved Property

SOURCE OF VALUATION

Appraisal

Market Evaluation

Tax Assessment

APPRAISER or REALTOR

First Name

Last Name

PHONE

(###)

###

####