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Finance Application
Title (Mr / Mrs): *
Name: *
Surname: *
Date of birth *
Home Tel: *
Mobile Tel:
Occupation:
Occupation Status: *
Time employed: *
Employer name: *
Bank account: *
Sort Code: *
Time with bank: *
Current Address: *
Time at Address: *
Previous Address:
Time at Address:
Employer phone:
Employer address: 
 
 
Credit cards: *
Please tell GLR if you have any other credit cards, if so which ones and how many (Mastercard, Visa, etc)
 
Finance details: *
Please tell GLR which scooter you are interested in purchasing and the deposit you wish to put down
(a minimum deposit of 25 pounds is required)