CREDIT APPLICATION

Please feel free to submit your credit information, we can pre-approve you to offer you the fastest, easiest, no hassle credit in East Texas. Once approved, the store of your choice will contact you and allow you to come shop with us at your convenience.

*Denotes Required Fields

* Full Name
* Social Security #
* Address
* City
* State
* Zip Code
* E-mail
* Telephone
* Date of Birth
* Driver License Number
* Driver License Expiration Date
Married  Single   
Co-Applicant Name (Spouse)
Social Security
Date of Birth
* Length of Residence
* Own/Rent/Buying
* Rent/mortgage payment amount
Previous Address
Employer
Occupation
How Long?
* Salary
Additional Income
Previous Employer
How Long
Credit Amount Needed
Credit Reference (Three)
Paid  Open
Paid  Open
Paid  Open
How did you hear about us?
Storeyou would like application to be forwarded to (see stores page)
Comments
 
I agree to allow Blake Furniture to check my credit and employment history for the purpose of validating accuracy and possibly opening an account with them.
 

Copyright © 2003 Blake Furniture. All rights reserved.