Tel: 0845 050 9363

Online finance application.
Use the form below to provisionally apply for finance.
By applying you are not Committing to yourself to any
contract. One of our trained staff will contact you on completion.
To apply please fill the form below.
Details of main applicant
Title:
Full Name:
Marital Status:
Date of Birth: (Month/Day/Year)
Driving License:
Number of Dependants:
Current Address

 

Address:
Postcode:
Telephone Number:
E-mail Address:
Mobile Number:
Time at this address: Years Months
Residential Status:
Previous address (if less than 3 years at current address
please use "N/A" in the appropriate fields if not applicable)

 

Previous Address:
Postcode:
Time at this address: Years Months
Occupation:
Employers Name:

 

Employers Address:
Work Telephone Number:
Time with Employer: Years Months
Net Income (Monthly):
Previous occupation (if less than 3 years at present -
please use "N/A" in the appropriate fields if not applicable)
Prev Employers Name:

 

Prev Employers Address:
Prev Work Number:
Time with Employer: Years Months
Make:
Model:
Reg: (see stock list)
Screen Price:
Deposit:
Part Ex:
Vehicle Mileage: miles
MOT Expires:
Outstanding Finance
Approx. Settlement

Applicants must be over 18 years of age. Credit subject to status and income. Licensed credit brokers. Written details on request.
Chapelhouse Finance is a trading name of Chapelhouse Trading Ltd,
Registered Office: Unit 3 Premier Business Centre, Attwood St, Stourbridge, West Midlands, DY98RU
Company No.: 6507620 Consumer Credit Licence No.: 614103
Stop Dreaming and Start Driving