You will need to have your account number handy to complete your application. Step 1 of 8 12% Account Number Amount Requesting* Purpose of Loan Name* Mr. Mrs. Miss Ms. Dr. Prof. Rev. Prefix First Middle Last Home Phone* Work Phone Mobile Phone Email Marital Status*Single Married Separated Divorced Widow Widower Number of Dependents* Please enter a number greater than or equal to 0. Ages of Dependents Separate each age with a space or comma. Address* Street Address Address Line 2 Christ Church Saint Andrew Saint George Saint James Saint John Saint Joseph Saint Lucy Saint Michael Saint Peter Saint Philip Saint Thomas Parish How long have you been at this address?* Please enter a number greater than or equal to 1. Employer Name* Employer Address* Street Address Address Line 2 Christ Church Saint Andrew Saint George Saint James Saint John Saint Joseph Saint Lucy Saint Michael Saint Peter Saint Philip Saint Thomas Parish Occupation* Length of time with Employer* Previous Employer* Previous Employer's Address* Street Address Address Line 2 Christ Church Saint Andrew Saint George Saint James Saint John Saint Joseph Saint Lucy Saint Michael Saint Peter Saint Philip Saint Thomas Parish References Budget Period*Weekly Monthly Income Gross Earnings Allowances Other Income ExpencesExpencesExcess Income Savings Statement of AffairsAssetsCreditors Preferred Location*Hincks Street, Bridgetown Sargeants Village, Christ Church Kensington Mall, Fontabelle Terms and Conditions Agreement* I agree to the Terms and Conditions. The Credit Union may verify any information provided to it by me/us from whatever sources it deems necessary. The Credit Union is hereby authorized to obtain any information it requires relative to my/our credit history or application for credit and any such resource is hereby authorized to provide the requested information. The Credit Union is further authorized to disclose to any Credit bureau, reporting agency, business, financial institution or person with whom I/we have entered into our purpose to enter into a business or financial relationship, personal information or such information regarding my/our credit or financial history, or information as is deemed appropriate, lawful and necessary at the sole discretion of the Credit Union or as expressly provided by law. I/we jointly and severally agree to indemnify the Credit Union and save the Credit Union from any and all claims in damages or otherwise arising from any disclosure as herein authorized.