All information is sent over a secure connection for your security!

We use these details, to confirm that it is you making the application and so that we can contact you easily.

We use these details to decide how easily and when you can pay us back. We do not inform your employer, or anyone else of your loan request.

Please read and accept our data protection policies, we cannot offer a loan until you check the box to accept them.

Your Payday Loan Application

• You can borrow up to £750 today!
• Simply fill in sections 1 - 3 below, and then we can make you a loan offer!
• By signing online now, we can send funds to your bank today!

Please correct the fields highlighted in pink below

1: Your contact details

Title Choose Mr. Ms. Mrs. Miss Other

First Name

Last Name

Email Address

Email Address
We will send you confirmation of your loan via email.

Re-type Email Address

Home Phone

Home Phone
Format: Area Code Number

Mobile Phone

Work Phone

Work Phone
If we need to contact you at work, we will do so without informing your employer of the reason for our call.
Format: Area Code Number

Date of Birth

Date of Birth
This helps us confirm your identity and that you are over 18 years old.
Format: dd/mm/yyyy

House Name/ Number

Street

Town/ City

County Choose Antrim Ards Armagh Bedfordshire Berkshire Belfast Ballymena Ballymoney Banbridge Borders Region Bristol Buckinghamshire Cambridgeshire Central Region Carrickfergus Craigavon Cheshire Channel Is Cookstown Coleraine Clwyd Cornwall Castlereagh Cumbria Dumfries and Galloway Region Derbyshire Devon Dungannon Dorset Down Derry Durham Dyfed East Riding of Yorkshire East Sussex Essex Fermanagh Fife Region Gloucestershire Grampian Region Greater London Greater Manchester Gwent Gwynedd Hampshire Hertfordshire Herefordshire Highland Region Isle of Man Isles of Scilly Isle of Wight Kent Lancashire Leicestershire Lincolnshire Limavady Londonderry Lothian Region Larne Lisburn Mid Glamorgan Middlesex Merseyside Magherafelt Moyle North Yorkshire North Down Northamptonshire Norfolk Nottinghamshire Newtownabbey Northumberland Newry and Mourne Omagh Orkney Is Oxfordshire Powys Rutland South Glamorgan Shetland Is Shropshire Somerset Staffordshire Strabane Strathclyde Region Suffolk Surrey South Yorkshire Tyne and Wear Tayside Region Tyrone West Glamorgan Western Isles West Sussex Warwickshire Wiltshire Worcestershire West Midlands West Yorkshire

Post Code

2: Your income & payday loan details

Loan Amount(£)

Loan Amount(£)
We provide payday loans between £80 and £750.
Money is sent to your bank on the same day!

Primary Income Choose Full-Time Employment Part-Time Employment Temporary Employment Self Employed Unemployed Pension Disability Benefits

Company Name

Paid by Direct Deposit Choose Yes No

Payday Frequency

Payday Frequency
We use this to work out when you can repay us after you have received your loan

Choose Last Working Day of Month Four-weekly Specific Day of Month Last Monday of Month Last Tuesday of Month Last Wednesday of Month Last Thursday of Month Last Friday of Month

Net Monthly Pay(£)

Net Monthly Pay(£)
This is the actual money you receive after TAX

Time with Employer Choose < 2 Years 2-4 Years 4-8 Years > 8 Years

Your Debit Card Choose Switch/Maestro Solo Visa Delta Visa Electron No Debit Card

Your Next Pay Date

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.
Format: dd/mm/yyyy

3: Acceptance of terms

I have read and accept MEM Consumer Finance Ltd's data protection policies* MEM Consumer Finance Ltd is a Subsidiary of MEM Capital Ltd

*As part of your application, we will check the files of a credit reference agency

Credit Reference Check
We credit score your application, so that we can offer you a loan immediately and online with no faxing of documents!