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Existing Client Application Form 

Please complete the form below.

* ALL NEW CLIENTS MUST APPLY WITH A NEW CLIENT APPLICATION FORM.  DOWNLOAD FORM HERE AND FAX TO 204-987-7188.

Existing Client Application
  1. First Name(*)
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  2. Middle Name
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  3. Last Name(*)
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  4. Birth Date (dd/mm/yyyy)(*)
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  5. Email (to receive Aski updates and specials)
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  6. Phone Number(*)
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  7. Employer (Company's Name)(*)
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  8. Amount of Loan Applying For(*)
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  9. Requested number of Repayment Periods (minimum 5 & maximum 8 pay periods )(*)
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  10. What is your net pay?(*)
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  11. Is this an Aski replacement card?(*)
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  12. If yes, please fax your client card agreement to (204) 987-7188
  13. How would you like your funds dispursed?(*)
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  14. (Direct deposits other than RBC can take up to 2 business days)
  15. Additional Comments
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  16. Verification(*)
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  17. Please enter the characters shown
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