Loan Application
Your Loan Details
Email Address:
Home Phone Number:Enter with no spaces
Used to confirm your loan
Loan Period:
Loan Amount:
Loan Purpose:
Your Personal Details
Marital Status:
Number of Dependants:
Your Home Details
Leave blank if not a homeowner
Leave blank if not a homeowner
Your Employment Details
Employer Name:
Pay Frequency:
Following Pay Date:
NI Number: (optional):
Job Title:
Time With Employer:
Paid into Bank Account:
Enter with no spaces
Your Financial Information
Mortgage/Rent Payment:
Monthly Utility Bills:
Debit Card Type:
Monthly Credit Payments:
Transport Expenses:
Bank Account Number: Enter 8 digit number
Other Monthly Payments:
Monthly Food Bill:
Bank Sort Code: No dashes or spaces
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Please Read
and Confirm
   We only want you to apply for a loan if you’re sure you can repay it in full on your due date and still manage your other outgoings. Please tick here to confirm you have provided accurate financial information and considered potential future income and outgoings in determining your ability to repay.

   Our brokerage service involves undertaking searches with our network of lending partners who may contact you in relation to your application.

This website is operated by its owners, information of who they are can be found within this website, and Lead Affinity will process your information. Please read our Privacy Statement and Terms for details of how the information you provide is processed and the terms and conditions. Please tick the box below to confirm you have read and understood the Privacy Statement and Terms and are happy that some lenders may carry out credit searches to determine loan suitability.

 Please indicate if you are happy for us to share your information with other carefully selected financial services organisations, other than those contacted from this application, so they can contact you about other products and services. This could be via telephone, SMS, post or e-mail. Please tick the box below to opt-out.

Warning: Late repayment can cause you serious money problems. For help, go to