Secure Application | Apply Payday Canada

To qualify, you need to:
• be over 18 years old
• be employed fulltime for at least 3 months
• take home more than 800$ per month after taxes
• be paid by direct deposit in a canadian bank account
• be a Canadian Citizen

Personal Information

First Name*

Last Name*

Email*

Confirm Email*

Date of Birth*

Sex*
Male Female

Home Phone Number*

Cell Phone Number*

Residential Information

Address*

Apt

City*

Province*

Postal Code*

Revenue Information

Source of Income*

Are you paid by?*

Pay Frequency*

How much do you receive every pay (after taxes) on average?*

Next Pay Deposit*

Following Pay Deposit*

Additional Information

How much would you like to borrow?*

Loan Purpose*

How did you hear about us?*

What is your credit score?*

Are you planning on declaring bankruptcy or entering a consumer proposal?* Yes No

Your Bank*

Have you ever declared bankruptcy in the past?*

Yes No

Institution Number*

By submitting this form, i confirm that the information i provide is exact and current,
and that i have read and accepted the terms and conditions.
I accept periodical contact by Apply Payday Canada by email with promotions
or updates regarding my account.