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Anagen Hair Extensions

Loan Application

Personal details:

Please ensure all mandatory fields marked with an asterisk (*) are populated.

Title*:

First Name*:

Surname*:

Date of Birth* (dd/mm/yyyy)

Country of Birth*

Marital Status*:

Number of Children*:

Years on Island*:

Contact Details:

Mobile Number*:

Home Number:

Work Number

Email*:

Home

Residential Status:

Current Address

Address Line 1*:

Address Line 2:

Parish:

Postcode*:

Years at Address*:

Months at Address*:

Previous Address

Address Line 1:

Address Line 2:

Parish:

Postcode:

Years at Previous Address:

Months at Previous Address:

Work

Current Employer

Employer*:

Occupation*:

Address Line 1:

Address Line 2:

Postcode:

Years at Current Employer*:

Months at Current Employer*:

Previous Employer

Employer:

Occupation:

Employer Address Line 1:

Employer Address Line 2:

Employer Postcode:

Years at Previous Employer:

Months at Previous Employer:

Your Loan Enquiry

Amount*:

Preferred Term (Months)*:

Reason for loan:

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The loan amount will be paid direct to Anagen once approved

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At Tupper Loans we take the importance of protecting your personal information seriously and are committed to processing it responsibly in compliance with applicable data protection laws

'Whatever your financial needs may be, everyone can benefit from TLC'