Apply online for the aqua Credit Card - MasterCard application

Applying online for an aqua credit card is quick and easy. If you’re approved, all you have to do is sign and return the credit card agreement that we will send you in the post. Alternatively you can request a postal application form to be sent to you.

To apply for an aqua card you must be aged 18 or over and be resident in the UK. Please answer the following questions fully and accurately as the information you supply will be used to decide whether you are approved for an aqua card.

For your security, when you submit your application it will be encrypted and sent to us over a secure connection.

Fields marked * must be completed.

About your past

1. About your past

Have you ever:

- been declared bankrupt?*

Yes

No

If you have been declared bankrupt:

How long ago was this?*:

Please select In the past 3 months In the past 12 months Over 1 year and less than 2 years Between 2 and 4 years ago More than 4 years ago

What is the value of your bankruptcy or IVA?*:

Please select Up to £250 £251-£500 £501-£1,000 £1,001-£2,000 £2001+

- received a CCJ?*

Yes

No

If you have received a CCJ:

How long ago was this?*:

Please select In the past 3 months In the past 12 months Over 1 year and less than 2 years Between 2 and 4 years ago More than 4 years ago

What is the value of your CCJ?*:

Please select Up to £250 £251-£500 £501-£1,000 £1,001-£2,000 £2001+

- received a default notice on a credit account?*

Yes

No

If you have received a default notice on a credit account:

How long ago was this?*:

Please select In the past 3 months In the past 12 months Over 1 year and less than 2 years Between 2 and 4 years ago More than 4 years ago

Question 2?*:

Please select Up to £250 £251-£500 £501-£1,000 £1,001-£2,000 £2001+

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About you

2. About you

Title: Mr Mrs Miss Other

If other:

First name*:

Surname*:

House no.*: and/or

House name: and/or

Flat no:

Address*:

Address line 2

Town/City*

Postcode (Part 1)*

 Postcode (Part 2)

What is your current residential status?*:

Please select Homeowner Private tenant Council tenant Living with parents Other

Your date of birth*:

Day: DD 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31

Month: MM 01 02 03 04 05 06 07 08 09 10 11 12

Year: YYYY 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1939 1938 1937 1936 1935 1934 1933 1932 1931 1930 1929 1928 1927 1926 1925 1924 1923 1922 1921 1920 1919 1918 1917 1916 1915 1914 1913 1912 1911 1910 1909 1908 1907 1906 1905 1904 1903 1902 1901 1900

Your email address (if you have one):

Your phone number*:

How did you hear about the aqua card?*:

Please select Search engine Advertising on a website Received an application form in the post Received an email Referred by Credit Gain Services (CGS) Referred by another broker Referred by another credit card provider Recommended by a friend

Please ensure you have read the declaration below:

aqua credit cards are issued by Bank of Scotland plc. By clicking "Continue" you agree that Bank of Scotland plc may use and disclose details it has about yourself as set out in the following link Security and Privacy. Bank of Scotland plc may also disclose details about me and my account to SAV Credit Limited for the purposes set out in the Conditions of Use. Members of the HBOS group of companies, together with the introducer or affinity partner, may use it to inform me by letter, telephone, e-mail or otherwise, about any products and services offered by the group or selected third parties. If you do not wish to receive this information please contact us on 0845 601 0436 or click here for details on how to opt out of this service. We will search credit reference and fraud prevention agencies to check your identity, credit status and help us make decisions. For this application, we will assess you on your own (except for another party to this application). You declare that your financial associate's finances will not affect our decision. We check your declaration and may decline the application if it is inaccurate. If false or inaccurate information is provided and fraud is identified, details will be passed to fraud prevention agencies to prevent fraud and money laundering. Further details explaining how information held by the fraud prevention agencies may be used can be obtained by reading the privacy notice or calling 0870 850 3858.