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Business Loan Inquiry
First Name
Last Name
Business Name
Business in Operation Since:
Did you receive a grant or loan from Park Community Credit Union between March and August 2021?
Yes
No
What is the street address of your business?
City
State
Zip Code
Number or owners/partners
Number of Employees
Are you located in, provide significant services to, or do most of your employees live in one or more of these neighborhoods: California, Chicasaw, Park DuValle, Park Hill, Algonquin, Parkland, Portland, Russell, Shawnee, Shelby Park, Smoketown?
Yes
No
How would you describe yourself?
American Indian or Alaska Native
Asian
Black or African American
Native Hawaiian or Other Pacific Islander
White
Other
How would you describe your ethnicity?
Hispanic
Non-Hispanic
Other
Do you have a disability of any kind?
Yes
No
How would you describe your gender?
Male
Female
Non-Binary
Prefer not to answer
Inquiry completed by:
Title or business relationship of party completing this eligibility questionnaire
Contact Email
Contact Phone
Submit
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