Does your organization have operations in Arizona?
Select one... Yes No

Is your organization profit or not for profit?
Select one... Profit Not for Profit

What type of project are you seeking financing for?
Select one... New Construction Renovation Equipment Other

If other, please describe:

What is the estimated total project cost?
Select one... 1 Million - 5 Million 5 Million - 10 Million 10 Million - 25 Million 25 Million - 50 Million 50 Million - 75 Million 75 Million - 100 Million 100 Million +

What internal funding sources are available including fund raising and equity?
Select one... 1 Million - 5 Million 5 Million - 10 Million 10 Million - 25 Million 25 Million - 50 Million 50 Million - 75 Million 75 Million - 100 Million 100 Million +

Approximately, when will funding be needed?
Select one... 0 - 3 Months 3 - 6 Months 6 - 9 Months 9 Months - 1 Year 1 Year +

Please provide any other details pertinent to the proposed project:


Contact Information:

Institution or Company Name:

Contact:

Phone:

E-mail:

Note: All fields are required.