Primary Applicant Full Name
*
First Name
Last Name
What is the purpose of this loan?
*
Need Cash Now (Promotional loan rates for $3,000 and under)
Personal (For loan amounts above $3,000)
Debt Deletion (Promotional loan rates to pay off other credit cards or loans)
VISA Credit Card
Line of Credit
What is the approximate amount you want to borrow?
*
Are you a current member of Illinois State CU?
*
Yes
No
Non-Member Collapse
Social Security Number
*
Date of Birth
*
Phone Number
*
Email
*
example@example.com
Preferred method of contact:
*
Phone
Text
Email
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
How long have you been at this address?
*
# of years
Rent/Mortgage Expense:
*
Who is your employer?
*
When was your starting date?
*
How many hours do you work per week?
*
What is your gross monthly income?
*
BEFORE TAXES
Member Collapse
Account Number
Last four digits of your Social Security Number
*
Phone Number
*
Email
*
example@example.com
Preferred method of contact:
*
Phone
Text
Email
Have you had a loan with us in the last 12 months?
*
Yes
No
Is your employer the same?
*
Yes
No
Who is your employer?
*
What is your gross monthly income?
*
BEFORE TAXES
Is your income the same?
*
Yes
No
What is your new monthly income?
*
BEFORE TAXES
Are you still at the same address?
*
Yes
No
What is your address?
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
How long have you been at this address?
*
(# of years)
Collapse Stopper
Are you applying with a joint owner?
*
Yes
No
Joint Owner Information Collapse
Joint Owner Information
The following questions should be answered by the Joint Applicant.
Are you a current member of Illinois State CU?
*
Yes
No
Joint Non-Member Collapse
Full Name
*
First Name
Last Name
Social Security Number
*
Date of Birth
*
Phone Number
*
Email
*
example@example.com
Preferred method of contact:
*
Phone
Text
Email
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
How long have you been at this address?
*
(# of years)
Rent/Mortgage Expense:
*
Who is your employer?
*
When was your starting date?
*
How many hours do you work per week?
*
What is your gross monthly income?
*
BEFORE TAXES
Joint Member Collapse
Full Name
*
First Name
Last Name
Account Number
Last four digits of your Social Security Number
*
Email
*
example@example.com
Preferred method of contact:
*
Email
Text
Phone
Have you had a loan with us in the last 12 months?
*
Yes
No
Is your employer the same?
*
Yes
No
Who is your employer?
*
What is your gross monthly income?
*
BEFORE TAXES
Is your income the same?
*
Yes
No
What is your new gross monthly income?
BEFORE TAXES
Are you still at the same address?
*
Yes
No
What is your address?
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Collapse Stopper
Are you interested in any other services? (Check all that apply.)
*
Checking Account
Auto Loan Purchase
Auto Loan Refinance
No, I am not interested in these services.
Are you already working with a Member Service Representative?
Yes
No
Name of employee you are working with:
How did you hear about this product?
*
Facebook
Billboard
Radio
Credit Union Website
Credit Union Staff
Friend/Family
Email
Dealership
Wheels and Deals
I inquired myself
Name of person who referred you:
Additional Comments:
*
Signature
*
Clear
Joint Owner Signature
*
Clear
Submit
Should be Empty: