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Personal details

Contact details

Home address

Bank details

Unless you are paying off creditors this is the account that we will pay the money to if your loan application is successful.

Loan details

%
£
Build up your savings as you repay your loan

Projected loan repayments

Financial information
Please specify your total income on a monthly basis

Benefits
Please specify your total benefits income on a monthly basis

Dependants

Expenditure

Enter your monthly expenditure on the following types of expenses. If they do not apply to you, enter 0 as the amount. The values you enter should be based on the monthly amount you spend on each type.

General expenses

Insurances

Utilities

Personal

Financial

Children

Lenders

List of current outstanding loans, hire purchase and finance agreements (e.g. buy now pay later)

Credit cards

List of any credit/store cards

Total expenditure

This section summarizes the monthly expenditure you expressed in the sections above.

Employment

Paying in to your credit union

If your application is successful, how would you like to pay in to your credit union?

£

Beneficiary details

In the event of my death, I nominate as the person to whom there shall be transferred such property in the Credit Union as may be mine at the time of my death.

As the person to whom there shall be transferred such property in the Credit Union as may be mine at the time of my death.

Health declaration

By clicking in the signature box below a tick will be inserted which will represent your electronic signature. As part of the sign up for membership we will be required to run a identify and verification check. If, for any reason, we are unable to verify your identity we will get in touch to arrange for you to provide us with your identity documents to complete the sign up process.

Please note that if your loan is approved you must call in to the branch to sign.