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Canada Wide Loans
Credit Application
How do you rate your credit on a scale of 1 to 10?
*
Please select
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10
Name
*
First
Last
Middle Name
Sex
*
Male
Female
Home Phone
*
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Were you referred to us?
Please provide the full name of who referred you.
Date of birth
*
MM
/
DD
/
YYYY
SIN
*
Your Social Insurance Number will allow us verify who you are.
Do you have a treaty card?
Yes
No
Cell Phone
###
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Email
*
Address
*
Street Address
City
Province
Postal Code
Canada
Country
Please provide us with your legal land address.
example: 123 Younge Street
How long have you lived at the above address?
*
Employment Status
*
Please select
Part Time
Full Time
Disability
Retired
Other
Employer
*
What do you do for them?
*
How long have you worked there?
*
How are you paid?
*
Please select
bi-weekly
weekly
bi-monthly
monthly
other
How much do you make each pay period?
*
$
Dollars
.
Cents
We are looking for the number before any deductions are taken off.
Do you have another source of income?
Yes
No
If yes, how much to you get from that source on a monthly basis?
$
Dollars
.
Cents
If yes, what is the other source?
Do you have a down payment available?
*
Yes
No
If yes, how much is available?
$
Dollars
.
Cents
Do you have a vehicle to trade in?
*
Yes
No
If yes, tell us about the vehicle you will be trading in...
Please include year, make, model, trim, KM's and overall condition.
What type of vehcile are you looking for?
*
