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Loan Application Form

Please complete all your details in the form below, and click submit when you have finished.

Member Details

Employment Details

Spouse/Partners Details (where relevant)

Current Financial Situation

I declare that I am indebted to the following:

Original Amount

Balance Outstanding

Monthly Repayment Amount

Bank/Building Society

Rent/Mortgage

Credit Card

Other

Previous Credit Union Loans

Amount

Date

Repayment Amounts

Repayment Frequency

1

2

3

Loan Details

Declaration

I declare that I am not indebted to any other Credit Union, Bank or Loan Agency either as a borrower or Guarantor, except as stated on this application. The statements herein are made for the purposes of obtaining the loan and are true to the best of my knowledge and belief.





Data Protection Act 1988 - I consent to the information contained in this application form being used by the Credit Union for the purposes of processing my application