Student Secured VISA Application

Please read over the Consumer Credit Card Agreement.

Agreement
 
 
IF less than 1 year at current address
 
Marital Status
Married
Single
Divorced
 
Pay Frequency
Weekly
Bi-Weekly
Semi-Mo.
Monthly
 
Reference
 
Other Information About You
Applicant
Yes
No
 
If you answer "Yes" to any question other than #1, explain below.
Are You A U.S. Citizen or Permanent Alien?
Yes
No
 
DO YOU CURRENTLY HAVE ANY OUTSTANDING JUDGEMENTS OR HAVE YOU EVER FILED FOR BANKRUPTCY, HAD A DEBT ADJUSTMENT PLAN CONFIRMED UNDER CHAPTER 13, HAD PROPERTY FORE CLOSED UPON OR REPOSSESSED IN THE LAST 7 YEARS, OR BEEN A PARTY IN A LAWSUIT?
Yes
No
 
Savings Secured Credit Card Pledge
Savings Pledge
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Signature
VISA Account Updater
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Security
  captcha code for visual authentication  number 8 letter V number 3 letter S