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2. The loan application has two steps: this eligibility form and a formal application. Eligibility approval does not guarantee you will receive a loan. It means you have met the basic qualifications to apply.

   All questionnaires/applications will remain confidential.

   Campbell County Economic Development staff will contact you with details on your next steps once your eligibility to apply is established.

   Thank you for your interest in applying for a CLiMB loan! Contact the Department of Economic Development via email or 434-332-9595 with questions.

4. Business Name*

   Name of Business as listed on your Campbell County Business License and state registration. Include DBA information if you are doing business under a different name.

6. Business Location Street Address*
7. Address Line 2
9. City*
10. State*
11. Zip Code*
13. Applicant Name*

    The applicant should be a person who owns 20% or more of the business, guarantor of the loan, or other person authorized to complete the pre-application questionnaire.

15. Applicant Title*

    Job title of applicant

16. Applicant Email*
18. Additional Owners (20% or More)

    Please include names and contact information (phone and/or email) for any additional owners of the business.

20. Proposed Loan Amount*

    CLiMB Fund Loans may be requested up to $25,000.

22. Plan for Loan Funds*

    Describe how you plan to use the funds.

24. Is your proposed or existing business located within the boundaries of the County of Campbell?*

    1. Yes
    2. No
26. Do you have other locations of your business outside of the County boundaries?*

    1. Yes
    2. No
28. Is your business registered with the Commonwealth of Virginia (SCC)?*

    1. Yes
    2. No
30. Do you believe you meet at least a 620 credit score?*

    1. Yes
    2. No
32. Does your company have the ability to make debt service payments on the CLiMB Fund loan, in addition to other business obligations?*

    1. Yes
    2. No
34. Have the business, owners, or guarantors declared bankruptcy within the last seven years?*

    1. Yes
    2. No
36. Are there any pending or current lawsuits involving the company or any of its principals?*

    1. Yes
    2. No
38. Do you or any officers of your company have any outstanding police, public, or legal issues?*

    1. Yes
    2. No
40. Age of Business*

    1. Start-Up Business (not yet open)
    2. New Business (open less than 3 years)
    3. Long-Standing Business (open at least 3 years)
42. Explanation of any answers above you wish to include:
44. How did you hear about this loan program?*

    1. Website
    2. Social Media
    3. Flyer
    4. Postcard
    5. Campbell County Staff Member
    6. IDA Member
    7. Friend or Family
    8. Campbell County Event Guide
    9. Other
Leave This Blank:


46. 1. Receive an email copy of this form.
47. Email address

    This field is not part of the form submission.

48. Submit

* indicates a required field