Forlongs Individual Account Application

Please note all fields are compulsory for you to complete in order for your application to be successfully completed. If you have any questions please contact our customer service team on customerservice@forlongs.co.nz or Ph 07 8479089.

 
 

Your Details

Title *
 
First Name *
 
Middle Name
 
Last Name *
 
Date of Birth *
 
 
 

Current Residential Details

Unit/Flat
 
Street Number *
 
Street Name *
 
Suburb
 
City *
 
Time at Current Residential Address *
 
Landline Phone
 
Mobile Phone
 
Preferred Contact Phone *
 
Email Address *
 
 
 

Current Postal Details:

Same as Above? *
 
Unit/Flat
 
Street Number *
 
Street Name *
 
Suburb
 
City *
 
 
 

Previous NZ Residential Address

Unit/Flat
 
Street Number *
 
Street Name *
 
Suburb
 
City *
 
Time at Above Residential Address *
 
 
 

Renters & Boarders

Are You Renting or Boarding? *
 
Agent/Landlord's Name *
 
Agent/Landlord's Phone *
 
$ Rent Payments *
 
Payment Frequency *
 
Proof of Rental Agreement or Boarding Agreement
Please attach a pdf of your rental or boarding agreement. If you are unable to, please bring with you when you visit instore.
 
 
 

Residency

Are You a Permanent NZ Resident? *
 
Are You on a Work Permit? *
 
If You Were not Born in NZ, How Long Have You Been Here? *
 
If on a Work Permit, When Does it Expire? *
 
If you are not a permanent NZ Resident please bring your passport with you when you finalise setting up your account.
 
 

Marital Status

Current Status *
 
Partner's Name *
 
Partner's Phone Number *
 
Partner's Work Place *
 
Partner's Occupation *
 
Does Your Partner Have a Forlongs Account? *
 
 
 

Current Employment Details

Income Source *
 
Current Employer *
Employer/Business Name
 
Contact Person *
 
Employer's Address *
 
Phone *
 
Occupation *
 
Time with Current Employer *
 
Please bring in Financials from Accountant when you finalise setting up your account.
 
 

Previous Employment Details

If current is less than 4 months.

Previous Employer *
Employer/Business Name
 
Contact Person *
 
Employer's Address *
 
Phone *
 
Occupation *
 
Time with Previous Employer *
 
 
 

Referees

 
 

1. Nearest Living Relative in NZ

Not living at the same address as you.

Title *
 
First Name *
 
Last Name *
 
Relationship to You *
ie. Brother, Daughter, Cousin
 
Current Residential Address *
 
Landline Phone
 
Mobile Phone
 
 
 

2. Nearest Living Relative in NZ

Not living at the same address as you or the first person stated.

Title *
 
First Name *
 
Last Name *
 
Relationship to You *
ie. Brother, Daughter, Cousin
 
Current Residential Address *
 
Landline Phone
 
Mobile Phone
 
 
 

Income Details

We require this information to consider your credit risk and ability to make repayments going forward.
This information is used when considering your account credit limit.

How Often Are You Paid? *
 
Please Attach Supporting Payslips
Please attach a csv or pdf of your payslips for last 2 months. If you are unable to, please bring with you when you visit instore.
 
Please Attach Supporting Bank Statements
Please attach a csv or pdf of your bank statements for last 2 months. If you are unable to, please bring with you when you visit instore.
 
Your Annual Income (before tax) *
 
Your Partners Annual Income (before tax) *
 
Bank Accounts Held
 
Cheque Account Balance
 
Savings Account Balance
 
 
 

Your Assets

Do You Own a House? *
 
Please Attach Proof of Address
Please attach a scanned copy (.pdf) of your power bill, rates invoice, or sale and purchase agreement. If you are unable to, please bring with you when you visit instore.
 
Do You Have a Mortgage? *
 
Which Bank Holds This Mortgage? *
IE. BNZ, ASB, TSB etc
 
Do You Have a 2nd Mortgage? *
 
Which Bank Holds This Mortgage? *
IE. BNZ, ASB, TSB etc
 
What Are The 2nd Mortgage Payments? *
$ Repayments per week / month
 
Do You Own a Vehicle? *
 
Model *
ie. Mazda 6
 
Year *
YYYY
 
Value *
 
Registration *
 
Do You Own a 2nd Vehicle? *
 
Model *
ie. Mazda 6
 
Year *
YYYY
 
Value *
 
Registration *
 
 
 

Your Outgoings

Do You Have a Loan From a Finance Company? *
 
What is The Name of That Company? *
 
$ Loan Amounts *
 
Repayments *
$ per week/month
 
Do You Have Any Other Loans From Finance Companies? *
 
What is The Name of That Company? *
 
$ Loan Amounts *
 
Repayments *
$ per week/month
 
Do You Have Any Other Loans From Finance Companies? *
 
What is The Name of That Company? *
 
$ Loan Amounts *
 
Repayments *
$ per week/month
 
Do You Hold Any of These Credit Cards?
 
Combined Credit Card limit *
 
Combined Current Card Balance *
 
Do You Have Any Outstanding Debts to Veda/Baycorp? *
 
 
 

Next of Kin

Contact Person *
 
Relationship to You *
ie. Brother, Daughter, Cousin
 
Contact Phone Number *
 
Contact Address *
 
 
 

Subscription Preferences

Would you like to receive your account statement via email? *
If you choose Yes your account will receive a $5 credit automatically
 
Would you like to subscribe to our promotional emails re:special offers and interest free deals *
 
 
 

Privacy Consent

The information submitted in this form will be used by the lender for the following purposes:
Assessing your credit worthiness, administering and enforcing your card account including updating and enforcing accounts and credit records with external agencies. You authorise the lender to obtain information about you from other sources as the lender reasonably requires, retain and use information about your card account and you, provide this information to related companies and agencies for the purpose above. Such information may be used in updating and maintaining credit reporting agencies files and databases, which are accessible to their customers. All such information will be held by the lender at its business address. 

I apply for credit from Forlongs Furnishings Limited ("the lender"). The information contained in this application is true and correct. I am not an undischarged bankrupt. I accept the terms and conditions applying to Card use and agree to the privacy statement (opens in a new window).

Your Name *
 
Date *
 
 
 
 
Confirmation Code
This system prevents spamming, please enter this code in the box below
Confirmation Code
 
Enter Code *
 
 
 
 
Call us on phone: 07 847 9089
 
 
Visit our store and our experienced staff will be happy to help
 
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