Loan Program Self-Assessment
Evaluate your eligibility and readiness for our loan program by completing this self-assessment.
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Current Employment Status
*
Employed full-time
Employed part-time
Self-employed
Unemployed
Retired
Other
What is your approximate monthly income?
*
Do you currently have any outstanding loans or debts?
*
Yes
No
If yes, what is your total monthly debt payment? (Leave blank if none)
Loan Readiness Self-Assessment
*
Rows
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
I understand the terms and conditions of the loan program.
1
2
3
4
5
I am confident in my ability to make regular loan payments.
6
7
8
9
10
I have a stable source of income.
11
12
13
14
15
I have reviewed my monthly expenses and budget.
16
17
18
19
20
I am aware of the risks associated with taking a loan.
21
22
23
24
25
How would you rate your overall financial management skills?
*
1
2
3
4
5
What is your primary reason for seeking a loan?
*
Please Select
Home purchase
Car purchase
Education
Debt consolidation
Business investment
Other
Please provide any additional information or comments about your financial situation or loan needs.
Submit Self-Assessment
Should be Empty: