Introducers application form:
* denotes mandatory field
Your name(Introducer) *
Your company name
Your company address
Your postcode
Your telephone*
Your email address
Your customers details
Their name
Their address
Their postcode
Their home telephone
Their mobile telephone
Their email address
About the person who requires the loan
Are they a home owner?
Yes
No
If so is the property owned jointly?
Yes
No
Loan amount required (£)
Loan terms required
Years
Months
Property value (approx) (£)
Property type
House
Flat
Do they have any loans or credit already secured on the property?
Yes
No
Outstanding Mortgage balance (approx) (£)
How did you hear about us?
I am a previous introducer
Yell
Thompson Local
Recommendation
Local Radio
Other
