Funding Application

Funding Application

The information collect on this web form will be used to generate a Funding Application in a PDF Form.  We will review your information and get in touch with you to discuss your business' financial needs.  If you prefer to give us a call prior to completing this web application you can do so at 252-231-2300 or send an e-mail at info@fidelisbusinessfunding.com.

Privacy Policy

Fidelis Business Funding Solutions, LLC recognizes, respects and protects the personal privacy rights of our clients. We are committed to providing security and privacy regarding the collection and use of our client’s information, as well as the personal information of all who visit our website. The following Privacy Policy explains how we use and protect the information about our clients. We ask that you read it carefully prior to submitting an application.  Please click on the button "Privacy Policy" for a detail description of why we collect and how we use your information.

Funding Application

Business Information

Number and Street
Enter Email
Confirm Email
Legal Business Structure *

Business Finanial Information

Do you currently have a cash advance balance open with another company? If yes, provide details *
Name of Company with open balance
Open Balance for Company 1
Name of company with open balance
Open Balance for company 2

Principle Owner Information #1

First
Middle
Last
Number and Street
Enter Email
Confirm Email

Principle Owner Information #2

First
Middle
Last
Number and Street
Enter Email
Confirm Email

Applicant Certification

The information provided in this application shall be kept confidential and will not be shared with anyone else.

Co-Applicant Certification

The information provided in this application shall be kept confidential and will not be shared with anyone else.