Loan Enquiry Form

Loan Enquiry Form

Submit your details to enquire about a loan with our credit union. To help us assess your enquiry, please complete this short form as accurately as possible. The details you provide will form the basis of an initial lending assessment.
YesNo
Full Name*

First NameLast Name
Email Address*
example@example.com
Phone Number*
Please enter a valid phone number.
Under 1818–2021–2526–3536–5051–6565+
Couple - No ChildrenCouple - With ChildrenSingle - No ChildrenSingle - With Children
If applicable ,Enter the total number and ages of dependents (children) you have under 18. Enter 0 if you have none.*
Current Address*

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Under 1 Year1 – 3 Years3 Years +
Living with parents/familyRentingOwner with mortgageOwner outrightOther
SingleJoint
Requested Loan Amount (EUR)*
Purpose of the Loan*
Full-time permanentFull-time contractPart-timeSelf-employedRetiredStudentUnemployedSocial welfare primary income
YesNo
Less than 3 months3–6 months6–12 months1–3 yearsOver 3 yearsNot applicable
Permanent ContractFixed Term ContractShort Term ContractPart Time ContractCID (Contract of Indefinite Duration)Not applicable
Your approximate NET monthly income (after tax):*
Monthly housing cost (rent or mortgage):*
Social welfare paymentsChild benefitMaintenanceRental incomeOvertime/commissionNone
Total monthly loan repayments (car loans, personal loans, HP etc.)*
€0Under €100€100 – €250€250 – €500Over €500
NoYes — onceYes — more than once
Under 1 year1–3 years3–5 years5+ years
NoYes
YesMaybe — want more informationNo
I consent to Drogheda Credit Union contacting me regarding membership and lending options.
Applicant Signature*

Clear
Should be Empty: