Apply Now! | Loan Application | RapidLoan.ca

Application Form

This is the application form for RapidLoan.ca

Name*
First Last
Social Insurance Number (SIN)*
Date of Birth*
YYYY slash MM slash DD
Phone
Email*
Enter Email Confirm Email
Address*
Address City Province Postal Code
Financial Information
I want to borrow ($)*
The amount you would like to borrow.
Please enter a number from 0 to 10000.
Gross Monthly Income
Your monthly income before taxes.
Please enter a number from 0 to 10000.
Net Monthly Income*
Your monthly income after taxes.
Please enter a number from 0 to 10000.
Source of income*
Employer Name*
Name of your employer or source of income
Additional Information
Are you over 18 years old?*
Are you currently in a non discharged bankruptcy?*
Are you currently in the process of resolving bankruptcy procedings?
Have you ever taken a consumer proposal?*
Have you ever had an agreement with a legal creditor to pay back less than the full amount owed?
Have you ever defaulted on a payday loan and not paid it back?*
Personal Reference
Name*
First Last
Phone*
Relationship*
Authorization

I certify the information contained in this application is true to the best of my knowledge. I also allow RapidLoan.ca to verify this information by running a credit check. I also understand that this information may be shared with select partners such as banks, credit unions or other loan providers, with the goal of providing you a loan.
I agree to the above statement*
- Disagree
- Agree
Proof of Income (optional)

Note: Proof of income is optional for the initial application but may required for the approval of the loan.
File
Max. file size: 12 MB.
Referral

If somebody referred you to RapidLoan.ca, enter their e-mail here
Referral Email
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Application Form

Financial Information

Additional Information

Personal Reference

Authorization

Proof of Income (optional)

Referral