Credit Card Application


Name *
Name
Primary Phone Number
Primary Phone Number
Physical Address
Physical Address
Do You:
$1,500 a month or $200 a week, etc,,,
Hire Date
Hire Date
Employment Status
$50,000 a year, $3,000 a month, $500 a week, etc...
Are you a U.S. Citizen or permanent resident alien?
Have you ever filed for bankruptcy protection?
Is your income likely to decline in the next two years?
By selecting this box, I agree to the terms stated below *
By selecting this box, I am acknowledging the solicitation disclosure below *

BY SUBMITTING THIS APPLICATION YOU AFFIRM THE FOLLOWING:

  • THE INFORMATION YOU HAVE STATED IN THIS APPLICATION IS CORRECT TO THE BEST OF YOUR KNOWLEDGE;

  • YOU AUTHORIZE THE CREDIT UNION TO OBTAIN A COPY OF YOUR CREDIT REPORT AND VERIFY YOUR EMPLOYMENT;

  • THE CREDIT UNION WILL RELY ON THE INFORMATION IN THIS APPLICATION AND YOUR CREDIT REPORT TO MAKE ITS DECISION;

  • IT IS A CRIME TO WILLFULLY AND DELIBERATELY PROVIDE INCOMPLETE OR INCORRECT INFORMATION ON THIS APPLICATION.

IF YOU HAVE A JOINT APPLICANT PLEASE HAVE THEM FILL OUT THE FORM BELOW.