Apply - Your Info - Fox Hills Cash

Returning Customers do not need to fill out another application - simply give us a call at 866-677-1500 and you can complete the process over the phone!

Personal Information

Loan Amount *

First time customers may qualify up to a max amount of $500

First Name *

Last Name *

Email Address *

Social Security Number *

Date Of Birth *

Contact Information

Street Address *

City *

State *

Zip Code *

How long at this address (Yr Mth) *

Home Phone *

Cell Phone *

Drivers License State *

Drivers License Number *

Military Status *

Federal law provides important protections to active duty members of the Armed Forces and their dependents. To ensure that these protections are provided to eligible applicants, we require you to sign one of the following statements as applicable:

I AM a regular or reserve member of the Army, Navy, Marine Corps, Air Force, or Coast Guard, serving on active duty under a call or order that does not specify a period of 30 days or fewer.

I AM a dependent of a member of the Armed Forces on active duty as described above, because I am the member's spouse, the member's child under the age of eighteen years old, or I am an individual for whom the member provided more than one-half of my financial support for 180 days immediately preceding today's date.

I AM NOT a regular or reserve member of the Army, Navy, Marine Corps, Air Force, or Coast Guard, serving on active duty under a call or order that does not specify a period of 30 days or fewer (or a dependent of such a member).

Please note it is important fill out this form accurately.

Loan application

Personal Information

Contact Information

Military Status *