Quick Cash Application

Need a little extra cash in between pay days? We offer a $300 loan with a non-refundable $20 application fee. This is not based on income or credit. However, there are some restrictions regarding employment and the amount of direct deposit coming to the credit union. Please call or visit a branch for more information.

Account Number

Full Name *

Cell Phone Number *

Social Security Number *

Date of Birth *

Address *

City *

State *

Zip *

Personal Email *

Employer *

Phone Number *

Hire Date *

Loan Conditions:

A member in good standing
Current Quick Cash Loan balance must be paid in full before applying
Some eligibility requirements. See credit union for details.
Currently have payroll deduction of at least $52.00 or net direct deposit to HealthShare CU
There is a $20.00 Non-Refundable Processing Fee paid at the time of application.

Please deduct $20 fee from my: *

If Approved I request the loan proceeds to be deposited into my Credit Union: *

It can take up to 48 hours from the time of application for funds to be deposited into your HealthShare CU account.

I understand by submitting this application a $20.00 non-refundable fee will be deducted from my HealthShare CU account listed above. All of the information in this application is true. I understand that section 1014 Title 187 U.S. Code makes it a federal crime to knowingly make a false statement on this application. You have my permission to check it. You may retain this application even if not approved. If this application is approved, I agree to honor the provision of the credit or loan agreement and security agreement covering my loan.

Signature *

Math Captcha *

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