Loan Application

Prince Bishops Community Bank

L O A N   A P P L I C A T I O N

You must complete this form in full before any loan decision can be made. When you apply for a loan you usually know why you need it and how much you would like. You should be confident that you can afford any repayments on loan and other credit. If you experience any issues with applications made on mobile and tablet devices, please call our Head Office on 01207 232351 to check we have received your application. We may request further information separately to process your application.

Personal and Address Details

Select Title:*
Date of Birth:*
Present Address:*
Years at Address:*
Previous Address:(if less than 3 years at address above)
Occupancy Type:*
Name of Landlord / Mortgage Provider:
Number of Dependents:*
Already a Member?:*
Membership No:
Phone - Mobile/Home:*

Loan Details

Loan Req £:*
Purpose (explain fully):*
Repayment Method:*
Repayment Frequency:

Judgements and Arrears

County Court Judgements:*
Rent or Mortgage Arrears?*
Details of anything you have answered yes to; we will consider all circumstances:

Employment and Other Income

Employment Status:*
Employer Name:
Employers Address/Tel No:
Job Title:
Date Employment Commenced:
Salary £:
Other Income:

Choose main source of other income from drop down list above and enter the amount you receive (and details of any other benefits received) in the Details Box below.


Regular Outgoings

Mortgage/Rent £:
Council Tax £:
Gas £:
Electric £:
Water Rates £:
Mobile/Broadband £:
Sky/Virgin £:
TV License £:
Food/Household £:
HP/Credit Cards/Store £:
Other Fines £:
Other Loan £:
Childcare £:
Other Borrowing:
Please provide details of selections above:
Information to Support Your Application:
How did you learn about us (you must select an option):*

By submitting this form, I declare that all the information I have entered on this is true and accurate to the best of my knowledge. Falsifying information will result in your loan application being declined. We may request further information to process your application, so please make sure you provide a valid email address.


Important: Your Personal Information
We may use credit reference and fraud prevention agencies to help us make a decision to lend money.