Unique Code
Primary Applicant Full Name
*
First Name
Last Name
Interest Rate
What is the approximate amount you want to borrow?
*
What will the funds be used for?
*
Dental Expenses
Medical Expenses
Home Repairs
Home Remodel
Car Repairs
Car Maintenance
Holiday Shopping
Educational Use
Computer
Appliances
Unexpected Bills
Family Emergency
Travel
Rent
Food
Gas
Utilities
Building Credit
Repairing Credit
Credit/Collection Consolidation
Lawyer Fees
Gift
How did you hear about the Personal Loan Promotion?
*
Email
Digital Sign
Website
Online Banking
Facebook
Instagram
Lobby TV
Lobby Handout
Member Service Representative
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
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
Disclosures and Agreements
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?
Please Select
Facebook
Billboard/Sign
Radio
Credit Union Website
Credit Union Staff
Friend/Family
Email
Dealership
Wheels and Deals
Event
University
I inquired myself
Name of person who referred you:
Additional Comments:
*
Signature
*
Joint Owner Signature
*
Submit
Should be Empty: