Elite Lender Application

Principal Owner Information

Name(Required)

First Last

Home Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

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Date of birth(Required)

Program/Offer Information

Business Legal Name(Required)

Offer Name(Required)

Please type the name of your course the exact way you would like it to appear on a student's financing application.

Offer Cost(Required)

This should be the total cost of your program including any supplies, fees, or other administrative costs. Do not include a range.

Length of Offer (in Days)*(Required)

This should be the total cost of your program including any supplies, fees, or other administrative costs. Do not include a range.

Enrollment in the Past 12 Months*(Required)

This should be the total cost of your program including any supplies, fees, or other administrative costs. Do not include a range.

Enrollment Type*(Required)

Method of Service Delivery*(Required)

Predominant Customer Education Background*(Required)

Admissions Prerequisites(Required)

Please list any admissions requirements, such as education, work experiences, testing or screenings, if applicable.

Typical Customer Job Title Post-Completion*(Required)

Please list any admissions requirements, such as education, work experiences, testing or screenings, if applicable.

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Do you have another course to add?*(Required)

Yes

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Attestations

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Lawsuits & Litigation(Required)

Yes

Are you party to any lawsuits or ongoing litigation?

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Data Security(Required)

Yes

Has your school experience any ransomware attacks or data breach incidents in the past 24 months?

Is your sales team compensated on the enrollment of new clients? (Enrollment numbers, price paid for the program, etc)*(Required)

Please upload three consecutive, recent bank statements from your main business operating account and your drivers license.

Month 1(Required)

Max. file size: 256 MB.

Month 2(Required)

Max. file size: 256 MB.

Month 3(Required)

Max. file size: 256 MB.

Copy of Drivers License(Required)

Max. file size: 256 MB.

Certification: I hereby certify that, to the best of my knowledge, the provided information is true and accurate

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Is your sales team compensated on the enrollment of new clients? (Enrollment numbers, price paid for the program, etc)*(Required)

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Company Information

Principal Owner Information

Program/Offer Information

Attestations

Please upload three consecutive, recent bank statements from your main business operating account and your drivers license.