Application Form

Applicant Information

Fill in the application below to apply to join a lending circle. This application form asks for some basic financial information so that we can review any applicants suitability for the program. Once your application has been reviewed, we will reach out to you. If your application is accepted we will then pull a credit check as the last step before you join a circle. This process is to insure that members of the lending circles are financially sound so that we can minimize risk for other members of a circle.

Full Name*

Please include your name.

Address*

Please include your address.

City/Town*

Please include your city/town.

Province*

Please include your province.

Postal Code*

Please include your postal code.

Phone Number*

Please include your phone number.

Email Address*

Please include a valid email address.

Date of Birth*

Please include your date of birth.

Emergency Contact*

Lending Circle Preferences

Why do you want to join this lending circle?*

Please include details.

Do you have a particular Lending Circle you want to join?

Invalid Input

Yes

No

Please make a selection.

Please include related details:*

Please include related details.

Are you currently a member of any other lending circles?*

Yes

No

Please make a selection.

If yes, please provide details:*

Please include details.

Do you already own a business?*

Yes

No

Please make a selection.

What is the name of your business?*

Please include the name of your business.

If you don’t own a business, what do you plan to use a Lending Circle loan for?*

Please include the type of business.

Financial Information

Monthly Income:*

Please include monthly income.

Other Sources of Income:

Please include details.

Current Debts/Obligations:*

Please include details.

Do you give permission for the lending circle to perform a background credit check?*

Yes

No

Please make a selection.

Community Engagement

Have you participated in any community service or volunteering activities?*

Yes

No

Please make a selection.

If yes, please provide details:*

Please include details.

How will you contribute to the lending circle?*

Please include details.

Are you in a position to make a monthly financial contributions as a member of a lending circle?*

Please include details.

References

Reference 1*

Please include reference name and contact information.

Reference 2*

Please include reference name and contact information.

Signature

I certify that the information provided is true and accurate to the best of my knowledge:

Signature*

Sign Above

Please include digital signature.

I certify that the information provided is true and accurate to the best of my knowledge.

*

Invalid

Lending Circle Application Form

Applicant Information

Lending Circle Preferences

Financial Information

Community Engagement

References

Signature

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