College Credit Card / Auto Loan Application

This form serves as a master loan application, covering all loans offered by Provident except real estate. …
School Information (Required)
School Name: | School Type: c 2-Year Month | c Part Time c Sr. c Graduate c Other c 4-Year c Trade School Year |
College Auto Loan/Credit Card Application
This form serves as a master loan application, covering all loans offered by Provident except real estate. The information you provide on this application will be kept permanently on file. We may ask for a copy of your most recent pay stub or income verification. When you want to borrow again, just call us with your updated information.
Co-Applicant/Joint Borrower (if applying for joint credit)
Last Name Social Security Number Birth Date Address First Name Driver’s License/I.D. Number Mother’s Maiden Name How Long (yrs/mos) M.I. State
Graduation Date:
Student Status: c Full Time Class: c Fr. c So. c Jr.
Type of Credit Requested
c College Auto Loan Amount Requested: $
College Checking Application
Member Number (new member–leave blank) Name Joint Owner Name Joint Owner Social Security Number Home Phone Number Driver’s License/I.D. Number Joint Owner Driver’s License Number Joint Owner Birth Date
Term (Years):
($15,000maximum) (Upto5years)
City/State/Zip Previous Address (if at current address for less than 2 years) Previous City/State/Zip Work Phone (Include Area Code) Employer Home Phone (Include Area Code) Job Title Department How Long (yrs/mos)
I would like to make my College Auto Loan payments through: c Automatic transfer from my Provident account:
(Withoutautomatictransfer,interestrateis2%higher)
c Checking
c Savings
c Standard monthly billing or coupons
Name of Beneficiary (if no joint owner or upon death of both owners)
c College Visa Card
Employer Address City/State/Zip Gross Annual Income Date of Hire
Check Options
In addition to my name and address (as it is on file at Provident), I would like my checks to be printed with the following options: c Phone Number c Joint Owner Name c Do not want Checks
Applicant
Member Number: Marital Status: c Married Number of Dependents: c Unmarried c Separated
Previous Employer (if current is < 2 yrs) Previous Work Phone (Include Area Code) Overdraft Protection Overdraft protection is automatic in the order listed below if applicable. Indicate below if you want a different order, or if you do not want overdraft protection: c Do not want overdraft protection Provident College Visa Savings Joint Owner Initial* Joint Owner Initial* Insurance Services Last Name Social Security Number Birth Date Address City/State/Zip Previous Address (if at current address for less than 2 years) Previous City/State/Zip Work Phone (Include Area Code) Employer Employer Address City/State/Zip Gross Annual Income Previous Employer (if current is < 2 yrs) Other Income Date of Hire Previous Work Phone (Include Area Code) Source Home Phone (Include Area Code) Job Title Department How Long (yrs/mos) First Name Driver’s License/I.D. Number Mother’s Maiden Name How Long (yrs/mos) M.I. State Provident Plus Insurance Agency, our subsidiary, can help you with insurance for your auto, home, and personal property. For a free quote or more information, call (800) 310-0395 or visit us online at providentcu.org/insure. If you already have a policy, a representative will provide you with a free quote approximately 30 days before your current policy expires. Initial and write the expiry date to receive a quote on the following policies: Auto Initial: Expires: Home Renter’s Initial: Initial: Expires: Expires: Money Market c Savings Joint Owner Initial* c Checking VIP Line of Credit Joint Owner Initial* *Jointownerapprovalisrequiredforoverdraftprotectionifthejointowneronyourcheckingaccountisdifferentfromthejointownersontheaccountsfromwhichyouroverdraftfundsaredrawn. Free Visa Check Card You and your joint owner (if applicable) will be issued and mailed a Visa