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Please correct the fields highlighted in pink below

1: Your personal details

First Name : This must be completed.<br /> If your name is 'John Brown', please enter 'John' not 'J'
Last Name : This must be completed.<br /> If your name is 'John Brown', please enter 'Brown'
Email Address : We will send confirmation of your loan via email.<br /> We will not pass on your email address to any third party.
Home Phone : Format: Area Code + Number<br />Example: 01234 123456
Mobile Phone : Without this we will not be able to offer you a loan.
Work Phone : If we need to contact you at work, we will do so without informing your employer of the reason for our call.
(dd/mm/yyyy)
Warning
Date of Birth : This helps us confirm your identity and that you are over 18 years old. <br />Format: dd/mm/yyyy
dd/mm/yyyy
House Name/ Number : Just the number or the name. This is not the first line of your address.
Name
Street Name : If the first line of your address is 123 Example Road, then your street is 'Example Road'
Town/ City : Example: Oxford
Post Code : With or without spaces

2: Your income & loan details

Loan Amount : Do not ask for more money than you really need!<br />The average loan is £200 and the more you ask for the lower your chances of approval.
Warning
Primary Income : You must be employed full time to qualify for a payday loan
Company Name : Tell us who you work for.
Time with Employer : How long have you been working for your current employer?
Payday Frequency : We use this to work out when you can repay us after you have received your loan. Note, we do not offer loans if you are paid weekly.
Your Next Pay Date : If your pay date is within 7 days, we automatically postpone repayment to your next pay date at no extra cost.<br />Format: dd/mm/yyyy
dd/mm/yyyy
Warning
Monthly Pay(£) : This is the money you receive after TAX.
Paid by Direct Deposit : Are your wages paid directly into your account?

3: Acceptance of terms

I have read and accept MEM Consumer Finance Ltd's data protection policies.

Submitting Application
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1: Your Personal Details

2: Your income and loan details

3: Submit Your Application

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