Self-Help Public Charter School Loan Application

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1 Self-Help Public Charter School Loan Application Thank you for your interest in Self-Help. We have been a charter school lender since 1997 and look forward to using our experience to serve your school. If you have not already discussed your school s project with a Self-Help loan officer, please do so before submitting a loan application. In this initial conversation about your school, project, and financing needs we will give you important information about the application process. This public charter school loan application includes several forms to complete as well as a checklist of additional documents required to review your loan request. Please sign the original copy of this application and send it to your loan officer. Be sure to retain a copy of the loan application for your records. Meredith Flowe (919) or (800) Steve Saltzman (919) or (800) Please send your completed loan application to your loan officer by or mail at: Attn: [Your Loan Officer] Self-Help P.O. Box 3619 Durham, NC For more information please visit:

2 Public Charter School Loan Application Checklist Instructions: Please use this checklist as you prepare your loan application. You should submit a copy of the checklist with your completed application showing the status of each item as either included, not applicable, or note the expected completion date. Also, if you are a charter school network, checklist items should be submitted for each school within your network. Please contact your loan officer with any questions. Also, please note that Self-Help may require additional items not included on this list in order to evaluate your application. Self-Help Forms Financial Organization Project Charter/ Authorizer Item Public Charter School Loan Application Notes Payable Schedule Credit Disclosure Statement Public Charter School Loan Consent Form Internal Financial Statements (3 years and year to date) CPA Audits (3 years) IRS Form 990s (3 years) Detailed Operating Budget (current and next year) Projected Operating Budget (5 years) Enrollment (past, current, and projected) Development Plan (strategy, committed gifts/grants, etc.) Organizational Chart (school and network if applicable) School Leader and Key Staff Resumes Board Member List Board Member Bios or Resumes Teaching and Administrative Staff List Strategic Plan Project Cost Plan (p. 8-9) Lease Agreement(s) (current and/or future) Property Purchase Agreement (if applicable) Construction Plans, Specifications, and Architect Contract Architect Qualification Statement General Contractor Qualification Statement Schedule for Completion of Project (at minimum, a timeline of important milestones) Construction Cost Estimate and/or Contractor Bids Zoning Verification ALTA Survey Property Appraisal* Phase I Environmental Site Assessment Charter Agreement and/or Application Current Enrollment Form (submitted to Authorizer) Reviews, Notices, and/or Warnings from Authorizer (since issue of charter) Status *Note: Property appraisal must be ordered by Self-Help s appraisal officer. Please contact your loan officer to faciliate appraisal order process if you have not already. 2

3 MANAGEMENT INFORMATION AND ACKNOWLEDGEMENTS Please read the following and sign below. Public charter schools, as non-profit organizations, should provide this information for the Executive Director, Board Chairperson, and Board Treasurer. The undersigned hereby certifies that the information contained in this application and related materials is true and correct. The undersigned hereby further certifies that the proceeds of any loan made as a result of this application will be used for business or organization purposes only, and will not be used for personal or consumer purposes. The undersigned hereby affirms that s/he does not and the organization does not discriminate on the basis of race, color, religion, national origin, gender, marital status or age. The undersigned hereby acknowledges that (1) no loan officer has authority to commit Self-Help to any loan without prior approval by Self-Help s credit committee and (2) any loan commitment must be in writing and signed by an authorized representative of Self- Help. Self-Help is authorized to make all inquiries Self-Help deems necessary to verify the accuracy of this statement and to determine the creditworthiness of the business or organization. The undersigned affirms that Self- Help has encouraged you to consult with other lenders, as Self-Help may not always be able to provide the best interest rate and terms available. The undersigned also authorizes Self-Help to answer question and inquiries from others seeking credit experience information about the business or organization. The undersigned hereby acknowledges that, regardless of the outcome of this loan application, Self-Help may use information drawn from this application and any related materials or due diligence in connection herewith in reporting to governmental agencies regarding Self-Help s lending generally, and/or its review of this application specifically. Executive Director Name (Print): Signature: Date: Board Chairperson Name (Print): Signature: Date: Board Treasurer Name (Print): Signature: Date: 3

4 Public Charter School Loan Application BORROWER DETAILS Today s Date: Legal Name of School: Physical Address of School: City, State and Zip Code: County: Mailing Address of School: City, State and Zip Code: County: Primary Contact Name: Primary Contact Title: Office Phone: Referral Source: Mobile: What is your legal structure? C Corporation S Corporation Nonprofit Corporation Legal Partnership Sole Proprietorship Limited Liability Corporation Fax: Are you considering changing your legal structure? Yes No Current number of employees: How many jobs will this loan create? Briefly describe your organization and what you will accomplish with this loan: 4

5 PROJECT INFORMATION* USES: Feasibility and Pre-Development Land/Building Acquisition Construction Hard Costs Construction Soft Costs General Costs FF&E Closing Costs Total Uses of Funds Public Charter School Loan Application (cont.) SOURCES: Self-Help Loan Requested Other Loan Sources Specify: Seller Financing Fundraising/Grants School s Cash Contribution Total Sources of Funds *In this section, your Uses should be transferred from the Project Cost Plan on p. 8 of this packet. The Total Uses of Funds must equal the Total Sources of Funds. COLLATERAL TO SECURE THIS LOAN Asset Value Property 1 $ $ Outstanding Loans Address Property 2 $ $ FF&E $ $ Other (specify): $ $ Other (specify): $ $ CHARTERING AUTHORITY INFORMATION Chartering Authority: Primary Contact: Phone Number: Address: Date Charter Issued: Expected Date of Renewal Review: Has your school ever received a warning from your authorizer? Yes No Does your school qualify as a charter school according to your state s definition of a charter school? Does your school qualify as a charter school according to the federal definition of a charter school? Yes Yes No No 5

6 Public Charter School Loan Application (cont.) ENROLLMENT INFORMATION Current Enrollment: (as of this date: / / ) Current Grades Served: Next Year Projected Enrollment: Next Year Grades Served: Enrollment Capacity at Current Facility: How many new student spaces will this loan allow your school to create? What is the maximum enrollment permitted under your charter agreement? Are you a Title I School? STUDENT INFORMATION Use data from most recently completed school year (20 /20 ), Total Enrollment: Eligible for Free/Reduced Lunch: Limited English Proficiency: Students w/ Disabilities: African American: Asian: Caucasian: Hispanic: Native American: Returning from previous school year: Waiting List: Students Retained for Most Recent School Year (from beginning to end of same year): FACILITY DETAILS Do you lease or own your current facility? Current Square Footage: Monthly Mortgage or Rent Payment $ Years in Current Facility: BOARD Board Chair: Phone Number: Address: Date Began Serving as Chair: / / Board Treasurer: Phone Number: Address: Date Began Serving as Treasurer: / / Length of Term: Length of Term: 6

7 Public Charter School Loan Application (cont.) PROFESSIONAL SERVICES Does your school use an educational services provider? Yes No If yes, what is the company s name?: Date Began Using (MM/DD/YY): Term of Current Contract: Annual Fees Paid for Services: $ What services are provided? How are fees calculated? CHARTER SCHOOL NETWORK Is your school a member of a charter school network? Yes No If yes, what is the network s name?: Date Membership Began (MM/DD/YY): Annual Fees Paid for Services: $ What services are provided by the network? How are fees calculated? 7

8 Project Budget ITEMS Feasibility and Pre-Development Concept Design & Preliminary Design Architecture Schematics (if construction) Civil Survey Phase I Environmental Report Traffic Study Land/Building Purchase Geotechnical Study Project Management Services Feasibility and Pre-Development Subtotal Land and Building Purchase Price Other Costs Relating to Purchase Land/Building Purchase Subtotal Construction Hard Costs Construction Contract (bid or cost estimate) Construction Contingency (typically 10% of Contract) Feasibility and Pre-Development Feasibility and Pre-Development Concept Design & Preliminary Design Archtecture Schematics (if construction) Civil Survey Phase I Environmental Traffic Study Land/Building Purchase Geotechnical Study Project Management Services Feasibility and Pre-Development Subtotal Land and Building Purchase Price Other Costs Relating to Purchase Land/Building Purchase Subtotal Construction Hard Costs Construction Contract (bid or cost estimate) Construction Contingency (typically 10% of Contract) Contractor Fee Payment and Performance Bond Builder s Risk Insurance (if not included in Contract) Construction Costs Outside of Contract (fence, security system, landscaping, playground, interior finish, etc.) Site Improvements Parking/Traffic Improvements Environmental Remediation Other (specify) COST 8

9 Project Budget (cont.) ITEMS Construction Hard Costs Subtotal Construction Soft Costs Architecture (full design, development & drawings) Civil Engineer Architect & Engineer Reimbursables Landscape Architect Landscape Reimbursables Project Management Services Other Consultant Services (Soils Engineer, etc) Building Permit Permit Expediter Fees Construction Loan Interest Lender Construction Inspection Fees Soft Cost Contingency (typically 10% of Soft Costs) Construction Soft Costs Subtotal General Costs Water and Sewer Tap Fees Utility Connection Fees (electric and/or gas) Hazardous Materials Survey Pest Remediation/Inspection FF&E Moving Costs Technology (cable, modems, hook-ups, etc) Signage Lease Deposit (if leasing) Upfit and/or Minor Renovation (if leasing) Other (specify) General Costs Subtotal Closing Costs Appraisal of Property ALTA Certified Property Survey Supplementary Environmental Studies Title Insurance Recording Fees Borrower s Legal Cost (formal opinion & other) Loan Commitment Fee Loan Origination Fee Lender Legal Costs Third Party Financing Fees (guarantees, seller-sub, etc) Financing Consultant Fees Insurance Costs COST 9

10 Project Budget (cont.) Incorporation Costs (if new corporate entity) Zoning Review and Opinion Other (specify) ITEMS Closing Costs Subtotal Equipment New Equipment for Facility Equipment Subtotal Working Capital Working Capital Request Working Capital Subtotal TOTAL ESTIMATED PROJECT COST Sources of Financing Self-Help Loan Other Loan Sources (specify) Seller Financing Fundraising Cash Contribution from Borrower Other (specify) TOTAL SOURCES OF FINANCING (must equal Total Project Budget) COST 10

11 Legal Name of School: Date (MM/DD/YY): Notes Payable Schedule Instructions: Please include on this schedule all existing notes and long-term leases of your school, including mortgages, revolving credit arrangements, equipment leases and any other type of debt, secured or unsecured. Creditor Original Balance Origination Date Current Outstanding Balance Monthly Payment Maturity Date Interest Rate Collateral (If real property, provide address.)

12 DISCLOSURE OF RIGHT TO REQUEST SPECIFIC REASONS FOR CREDIT DENIAL The undersigned Applicant hereby acknowledges that s/he is aware that under the provisions of the Equal Credit Opportunity Act, s/he has the right to receive a written statement of specific reason(s) for the denial if this application for credit is denied. To obtain the statement, please contact Self-Help within sixty (60) days from the date of notification of the credit denial. Self-Help Commercial Lending 301 West Main Street P.O. Box 3619 Durham, NC Self-Help will send the Applicant a written statement of the reason(s) for the denial within thirty (30) days of receiving the request for the statement. Applicant Signature: Date (MM/DD/YY): 11

13 PUBLIC CHARTER SCHOOL LOAN CONSENT FORM In connection with the application of (the Borrower ) for a commercial loan from Self-Help, Borrower understands and agrees that: INITIAL ALL THAT APPLY 1. Self-Help has entered into arrangements with third parties, including other lenders and government agencies, to establish programs that allow Self-Help to offer its customers beneficial loan terms and conditions that may not otherwise be available. In order to be eligible for these programs, Borrower agrees that Self-Help may disclose to such third parties any and all information about Borrower, its business and the loan from Self-Help to Borrower as may be required under the programs. 2. Borrower grants to Self-Help the permission to use Borrower s and its employees names, photographs, likeness, images, trademarks, service marks, logos, and any and all other information about Borrower for promotional purposes in brochures, advertisements, marketing materials, annual reports, websites, videos, and any other form of media, now or hereafter existing. Self-Help means Self-Help Credit Union, Self-Help Ventures Fund, the Center for Community Self-Help, Self-Help Community Development Corporation, and its affiliates. By signing below, I certify that I am authorized to sign this consent on behalf of the Borrower. Name (Print): Signature: Title: Date: 12

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