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Credit Application

Dealer

Applicant Info

Date Of Birth
Day
Month
Year
Drivers License Expiry
Day
Month
Year
Please Select Gender
Female
Male
Marital Status
Married
Common Law
Single

Current Physical Home Address

Province
Years At Address
Months At Address

Housing Info

Ownership

Employment Info

Self Employed
Yes
No
Years at Job
Months at Job
Employment Status
Full Time
Part Time
Retired

Interested In

Are you currently working with one of our fantastic sales team members?

Credit Authorization

By checking this box, I consent to the collection, use and disclosure of my personal information as described in this paragraph. I agree that the personal information provided above may be used and disclosed by Banner Recreational Products and/or its agents or service providers (collectively, the Dealer) as necessary to obtain credit, financial and related personal information (including a credit or consumer information report) about me from any credit bureau or credit reporting agency, and to advise me on credit availability in connection with product and/or service purchase financing. I further agree that the personal information provided above may be disclosed to the provider of Dealer’s website hosting or related services for the purpose of enabling Dealer to access my personal information for marketing purposes. Personal information I provide and credit information obtained may also be retained by Dealer and used to facilitate the application process should I subsequently choose to apply for credit through Dealer.*

Yes
No
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