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Cash Back Visa* Card Credit Application

  • Terms & conditions1
  • Tell us about yourself2
  • Residence3
  • Employment information4
  • Additional information5

Terms & Conditions

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Consent can be withdrawn at any time by contacting Collabria.
Phone: 1.855.341.4643
Mail: Suite 450, 110-9th Ave SW, Calgary, AB T2P 0T1
Email: info@collabriafinancial.com

I consent to receiving promotional emails from Collabria Financial Services Inc.

Important information

Please use the scroll bar on the right to view the entire Terms and Conditions. If you are unable to view the following Terms and Conditions, please click here.

Terms & Conditions

Terms and Conditions

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Declaration

  • Everything I will state in my application is true and correct.
  • My personal credit history is clear of bankruptcies within the past 36 months.
  • I have read and agree to all the pricing and other terms in the Terms and Conditions. 
  • The terms of my account are subject to change.
  • I consent to the collection of device-identifying data by a trusted partner.
  • I acknowledge that any owner of the account, its servicers, successors and assigns, may verify or reverify any information contained in this application or obtain any information or data relating to the account, for any legitimate business purpose through any source, including a source named in this application or a consumer reporting agency.

Tell Us About Yourself

Let's get to know each other

Please enter your full legal name (as it appears on your driver’s license or passport, for example).

What is your Social Insurance Number? (optional)

Your SIN helps us confirm your identity and process your application faster.

What is your date of birth?
 
What is your gender?
What is your mother's maiden name?
 
What is your email address?

We'll email you once your account is open.

 
Where can we reach you?
Member Number

Residence

Where do you live?
 
 
 
 
 
How long have you lived at your present address?
What is your residence status?
What is your monthly housing payment?
$  

Employment Information

Tell us about your employment
 
What is your field of employment?
What is your level of study?
What is your work phone number?
How long have you worked at your present place of employment?
What is your monthly gross income?
$  
How long have you been unemployed?

Additional Information

Promotional Code
Referred By
Intended use of the credit card
Are you an employee of the financial institution?
Would you like to add an additional user and apply for joint credit?
 
What is their name?

Please enter their full legal name (as it appears on their driver’s license or passport, for example).

Date of Birth
 
Mother's Maiden Name
What is their gender?
Are you an employee of the financial institution?
Where do they live?
 
 
 
 
 
How long have they lived at your present address?
What is their residence status?
What is their monthly housing payment?
$  
What is their email address?
 
Where can we reach them?
Member Number
Tell us about their employment
 
What is their field of employment?
What is their level of study?
How long have they worked at your present place of employment?
What is their monthly gross income?
$  
How long have they been unemployed?
Note: By adding a co-applicant, each applicant will have the right to use the account to the extent of the credit limit on the account and will be liable for all credit extended under the account to any co-applicant.
Would you like to add an authorized user?
What is their name?

Please enter their full legal name (as it appears on their driver’s license or passport, for example).

When is their birthday?
 
What is their country?
 
What is their gender?
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