Apply for Financing - LumiGrow Smart Horticultural Lighting

LumiGrow Financing Application

Interested in paying for your purchase with monthly installments? To see if you qualify for financing,
complete the credit application below. Feel free to ring us at 1-800-514-0487.

Apply Now

Company Information
Business Legal Name*
DBA*
Entity Formation
State of Formation
Federal Tax ID
Established Date of Current Ownership
MM slash DD slash YYYY
Phone Direct
Phone Mobile
Total # of Employees
Industry Type
Web Address
Headquarter Street Address*
City*
State*
ZIP Code*
Is Billing Address same as Headquarters?
- Yes
- No
Billing Street Address*
Billing City*
Billing State*
Billing ZIP Code*
Primary Contact/Application Submitter
First Name*
Last Name*
Title*
Email*
Direct Phone*
Mobile Phone
Technlogy and Finance Information
LumiGrow Sales Rep
Products Requested
Equipment Location Street Address
City
Requested Amount*
Requested Delivery Date
MM slash DD slash YYYY
State
ZIP Code
Requested Term
Bank Reference
Bank Name
Account #
Contact Name
Contact Phone
Finance Company Name
Lease/Loan #
Contact Name
Contact Phone
Contact Email
Vendor References 01
Vendor Company Name
Account #
Contact Name
Contact Phone
Contact Email
Vendor References 02
Vendor Company Name
Account #
Contact Name
Contact Phone
Contact Email
Vendor References 03
Vendor Company Name
Account #
Contact Name
Contact Phone
Contact Email
Owners, Officers or Guarantors
First Name*
Last Name*
Email*
Title*
Direct Phone*
Mobile Phone*
Social Security #*
% Ownership*
Home Street Address*
City*
State*
ZIP, Postal Code*
Campaign ID

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800-514-0487|info@lumigrow.com

Financing

LumiGrow Financing Application

Apply Now

Company Information

Primary Contact/Application Submitter

Technlogy and Finance Information

Bank Reference

Vendor References 01

Vendor References 02

Vendor References 03

Owners, Officers or Guarantors

Financing

LumiGrow Financing Application

Apply Now

Company Information

Primary Contact/Application Submitter

Technlogy and Finance Information

Bank Reference

Vendor References 01

Vendor References 02

Vendor References 03

Owners, Officers or Guarantors

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