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Tel: 01604 250016 Email:

22 October 2017
Online Loan Application

Please read carefully before applying.

Loans can take up to 3 working days before you hear a response from us.

Some loans may take longer to process, this will be because we require more information from yourselves. We will advise you what additional information we require within 3 working days. Once we have received the additional information, we require a further 3 working days to reach a final decision on the loan.

If you have any questions, please email us at or phone the Credit Team on 01604 250016, between 9.30am - 4.30pm, weekdays only.

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

Online Loan Application
* Required Fields
Member No:
Title: *
Full Name: *
Date of birth: *
National Insurance Number: *
No. of dependants: *
Marital Status: *
Address Line 1: *
Address Line 2:
Address Line 3:
Address Line 4:
Town: *
Postcode: *
Length of time at address (if less than 3 years,
provide previous address) In Years and Months:
Previous addresses:
Length of time at address (if less than 3 years,
provide previous address) In Years and Months:
Residential Status: *
Are you currently employed? *
Net monthly income:£ *
Net monthly expenditure:£ *
Loan amount required:£ *
How long I need to pay back loan? (Max 5 years): *
Loan purpose: *
Additional information (optional):
Home Phone No: *
Mobile Phone No: *
Email Address: *
Data Protection Statement
* Required Fields
In accordance with the principles of the Data Protection Act 1998, we will use your personal details for the purposes of managing your accounts with the Credit Union. Your personal details will be treated confidentially and will only be shared with other agencies for the purposes of credit referencing and debt recovery, for which purpose we hold a Category F consumer credit licence. We may at times use your details to keep you informed of services available from the Credit Union.
I declare, to the best of my knowledge and belief, that
1) I am not indebted to any other Credit Union, Bank or Loan Agency either as a borrower or a Guarantor, except as declared as part of my net expenditure;
2) I authorise the Credit Union to obtain any further information as required from my employer or credit reference agency;
3) ALL STATEMENTS CONTAINED IN THIS APPLICATION ARE COMPLETE AND ACCURATE TO MY BEST KNOWLEDGE'S/ BELIEF and I acknowledge that if any information given in this application proves incomplete or inaccurate, any loan to me as a result of this application may become immediately repayable to the Credit Union;
4) I understand that the provision of false information is fraud and that the Credit Union may take appropriate action if I am found to have deliberately provided false or misleading information;
5) I understand that in the event of loss of my income / employment due to an accident, redundancy or sickness, I will still be required to pay my agreed loan repayments;
6) I understand that upon approval of any loan to myself, I will be required and become a full adult member of the Credit Union and will not be granted the loan funds until this has been completed. By signing this declaration, I am allowing the Northamptonshire Credit Union to do an online identification check to verify my identity. I understand if I do not pass the online check, I will be required to provide additional supporting documents in order to register my account.
By ticking this box, I confirm that I have read and understood the declaration above
By ticking this box you are confirming the information above is correct and you are consenting for us to obtain information from your employer and credit file: *I Confirm
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Northamptonshire Credit Union Tel: 01604 250016 Email: Web:
Northamptonshire Credit Union is authorised by the Prudential Regulation Authority & regulated by the Financial Conduct Authority & the Prudential Regulation Authority (FRN 213810)