Fill out the application below by pasting it to MS Word, filling out the specified information. Print and Fax it to our Credit Department and you will receive you approval decision via email, telephone, or by letter.
Wilborniti' Credit Department
Email: wilborniticreditdepartment@yahoo.com
Fax: (801) 504-2340
Good Luck
WILBORNITI CREDIT APPLICATION
Applications are considered for credit without regard to race, color, religion, sex, national origin, age, marital or veteran status, or in the presence of a non-related medical condition or handicap.
Name_______________________________________________________Date______________
Credit Card Applying for:_______________________________________
Address___________________________________________________Phone #___________________
City_____________________State_____Zip__________Social Security #_______________________
DOB_________________Are you a citizen of the United States of America? [ ] Yes [ ] No
Have you ever used another name, AKA, or alisas? [ ] No if [ ] Yes ____________________________
Have you applied for this card before? [ ] Yes [ ] No When?______Position applied for?_________________
EMPLOYMENT EXPERIENCE; Start with your present job or last job. Include military assignments and other volunteer activities. Exclude organizational names which indicate race, color, religion, sex, or national origin
Employer 1__________________________________________________________________________
Address___________________________________City________________State_____Zip__________
Phone #________________Supervisors¡¯ Name_____________________________________________
Job Title______________________Reason for leaving_______________________________________
Dates of Employment: From_________To__________Salary or Hourly rate______________________
Employer 2__________________________________________________________________________
Address___________________________________City________________State_____Zip__________
Phone #________________Supervisors¡¯ Name_____________________________________________
Job Title______________________Reason for leaving_______________________________________
Dates of Employment: From_________To__________Salary or Hourly rate_____________________
Employer 3__________________________________________________________________________
Address___________________________________City________________State_____Zip__________
Phone #________________Supervisors¡¯ Name_____________________________________________
Job Title______________________Reason for leaving_______________________________________
Dates of Employment: From_________To__________Salary or Hourly rate______________________
EDUCATION
Schools/Collages Attended:
#
Years Year Grad. Degree ____________________________________________________ _______ _______ ___________
____________________________________________________ _______ _______ ___________
____________________________________________________ _______ _______ ___________
Drivers License #_______________________________State__________Expiration_______________
Email Address: ______________________________________________________________________
Are you a veteran of the U.S. Military service? [ ] Yes [ ] No
I CERTIFY that answers given herein are true and complete to the best of my knowledge. I authorize investigations of all statements contained in this application for credit as may be necessary in arriving at an credit decision. I understand that this application is not intended to be a contract of employment. In the event of credit approval, I understand that false or misleading information given on my application or interview may result in termination of my account.
Signature___________________________________________________Date_____________________
For Personnel Department only Remarks____________________________________________________________________________ ___________________________________________________________________________________ __________________________________________Interview report by__________________________