Flexi-Credit Application
Note: ALL fields marked with an "*" are mandatory.
Membership number: *
Full name: *
Flexi value required: *
Repayment frequency: *
Repayment value: *
Loan purpose: *
If other: please state:
Address details
House/Flat number and street name: *
Address Line 2: *
City/Town: *
Post code: *
Home status: *
Time at address: years * months *
Additional details
Home telephone:
Mobile telephone:
Email address: *
Dependants: *
Work details
Are you currently employed: *
Income frequency: *
Salary/Wage: *
Partners income: *
Benefits: *
Pension: *
Total income:
Expenditure frequency: *
Rent/Mortgage: *
Council Tax: *
Electricity: *
Gas: *
Telecommunications: *
Groceries / Food: *
Catalogues: *
Credit card(s) / Store card(s): *
Hire purchase: *
Car loan: *
Other loan(s): *
Fares/Petrol: *
Clothing: *
Pension: *
Savings / Investments: *
Home insurance: *
Car insurance: *
Life assurance: *
Entertainment: *
Total expenditure:
Initial withdrawal (if approved)
Disbursement method: *
* Payments into a building society require you to quote your roll number otherwise the payment will be rejected.

I confirm that the information given is true and complete to the best of my knowledge and belief. I also authorise you to make any credit reference checks and other enquiries in accordance with your procedures in connection with this application. I agree that the information obtained about me as a consequence of this and / or any other application and agreement which I have made with the Credit Union may be held on computer. I will not discuss or disclose details of my dealings with the credit union with / to any other parties.

Authorised by the Prudential Regulation Authority and Regulated by the Financial Conduct Authority and the Prudential Regulation Authority. Registration Number 213743.

* Please note - Any loan applications may be subject to a credit reference agency search.

Contact details
Preferred means of telephone contact: *
To help prevent spam, using only numbers, what is 7 + 3: *
"Submitting this form is my agreement that LCCU may contact me by email concerning LCCU business."