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Apply for a Loan
Please complete all your details in the form below, and click submit when you have finished.
You will be contacted for any addtional information required

If you are not already a member you will need to complete a membership application form which can be downloaded from the forms section. Please also check our loans section to check which loan is best for you.
Your Details
Forename:
Surname:
Member No:
Address:
Post Code:
Phone (Day):
Phone (Evening):
Date of Birth: (dd/mm/yyyy)
NI No:
Status:
No. of Children:
Ages:
Residence Status:
Time at this Address: Years
If less than 3 years at this address, please give previous address
Previous Address:

Employment Status
Are you employed:
Occupation:
How long have you worked at your present job:
Employer's Name:
Employer's Address:

Loan Details
Loan Type:
Purpose of Loan:
Date Loan Required (not asap): (dd/mm/yyyy)
(Turnaround time 5-7 working days)
Amount Requested:
Plus Existing Balance:
Total Required:
What is your Share Balance:
I want to repay my loan by installments of:
Repayment Frequency:
I wish to pay my loan by:
Collect At: (For bank transfer and Alto card Loan Agreement has to be already signed)

Who else do you owe money to?
Please list all Loans, Credit Cards, Catalogues, Hire Purchase etc.
Account Number Name of Creditor/Lender Purpose of Loan Limit Original Amount Balance Owing Weekly/Monthly Repayments

Net Income/Expenditure Details
(Please list all household income and expenditure, plus balances of other borrowings and savings and value of assets i.e. house, car, life policies etc.)
Net Income Item per Week per Month
Salery/Wages
Partners Income
Income Support
Job Seekers Allowance
Incapacity Benefit
Child Tax Credit
Working Tax Credit
Child Benefit
Carers Allowance
Pension
Pension Credits
Disability Living Allowance
Other
Other
  
Expenditure Item per Week per Month
Rent/Mortgage
Council Tax
Electricity
Gas
Telephone
Mobile Phone
Groceries
Catalogues
Credit Cards
Hire Purchase
Car Loan
Other Loans
Travel
Clothing
Pension
Savings/Investments
Home Insurance
Car Insurance
Life Insurance
Satellite/Cable TV
Broadband
TV Licence
Other
Other
Other
 





                         Office :   LACU c/o The John Loughborough School, Holcombe Road, Tottenham, London N17 9AD.
                                 Mobile :  07930 854730  Email :   info@lacu.co.uk