MEFA Private Loans - Online Application

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Application Type (Errors) Edit

^* Required field

Type of Degree:^*
Undergraduate Graduate

Are you the student?^*
Yes No

Degree Type:

Are you the student?

Applicant Information(Errors) Edit

^* Required field

First name:^*

Last name:^*

Middle initial:

Date of birth:^*(mm/dd/yyyy)

Social security number:^*

Confirm social security number:^*

Citizenship status:^*

Alien ID:^* (Required if Permanent Resident)

Primary phone:^*

This is a mobile phone:^*
Yes No

Primary Email address:^*

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First name:

Middle initial:

Last name:

Social security number:

Date of birth:

Citizenship status:

Alien ID:

Primary phone:

This is a mobile phone:

Secondary phone:

This is a mobile phone:

Primary Email address:

Applying with a co-borrower?

How Many Co-Borrowers?

Applicant Address (Errors) Edit

Current Address

P.O. Boxes are not allowed.

^* Required field

Street address:^*

Unit or apartment:

City:^*

State:^*

Country:^*

Zip code:^*

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Current Address

Street address:

Unit or apartment:

City:

State:

Country:

Zip code:

Disclosure and Privacy Policy

Electronic Communication Disclosure and Privacy Policy

I have read, understood, and consent to the language and authorizations outlined in MEFA Electronic Communication and Signature, and MEFA's Privacy Policy. We recommend that you retain a copy for your reference.

Loan Information (Errors) Edit

^* Required field

School:^*

Loan Amount:^*

Grade Level:^*

Academic Period:^*

Expected Graduation Date:^*

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School:

Academic Period:

Loan Amount:

Grade Level:

Expected Graduation Date:

Applicant Resident / Employment Information (Errors) Edit

^* Required field

Residence

Housing:^*

Total Monthly rent or Mortgage payment:^*

Current Employment

Employment status:^*

Employer name:^*

Time at Employer:^*

Years

If less than 5 years, please enter Previous Employment.

Gross monthly employment income:^*

Other monthly income:^*

Previous Employment

Employment status:^*

Employer name:^*

Time at employer:^*

Years

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Residence

Housing:

Total Monthly rent or Mortgage payment:

Current Employment

Employment status:

Employer name:

Time at employer:

Gross employment income:
Monthly: Annual:

Other income:
Monthly: Annual:

For Wisconsin Residents (Errors) Edit

You indicated that you are a resident of Wisconsin. If you are married, and your spouse is not co-borrowing this loan, Wisconsin law requires that we notify your spouse that credit has been extended to you. Please complete the following:

	I am not married.
	I am married, but I am applying without a co-borrower.
	My co-borrower is my spouse.
	I am married and the co-borrower is not my spouse.

Please enter your spouse's name and current address.

Spouse's Contact Information

First name:^*

Middle initial:

Last name:^*

Current Address

Same as my Current Address

Street address:^*

Unit or apartment :

City:^*

State:^*

Country:^*

Zip code:^*

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Spouse's Contact Information

First name:

Middle initial:

Last name:

Current Address

Street address:

Unit or apartment :

City:

State:

Country:

Zip code:

Student / Co-Borrower Information (Errors) Edit

Please enter your co-borrower's name and email address below.

Co-borrower's first name:^*

Co-borrower's last name:^*

Co-borrower's email address:^*

Confirm Co-borrower's email address:^*

Second Co-borrower's first name:^*

Second Co-borrower's last name:^*

Second Co-borrower's email address:^*

Confirm second co-borrower's email address:^*

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Co-borrower's name:

Co-borrower's email address:

Second Co-borrower's name:

Second Co-borrower's email address:

Authorize and Submit

Please read, acknowledge, affirm and consent to the disclosures, certifications and authorizations below, which include, among others, your certification of the use of proceeds of the loan for which you are applying and of the student's enrollment status, authorization to be contacted by voice or SMS text message regarding this application and such loan, consent to use of your electronic signature on this application and consent to electronic email and online communications from MEFA instead of regular postal mail. This summary is not intended to be comprehensive, and you should read and understand each item below fully before clicking the "Agree and Submit" button below to provide the requested certifications, authorizations, acknowledgments and consents.

I have completed this application to obtain credit, and by submitting this application agree to the following:

I certify under penalty of perjury that the statements contained in this application are true and complete, including but not limited to the certification that the proceeds of this loan will be used only for expenses constituting costs of attendance (as defined in 20 U.S.C. 1087ll) at the not-for-profit educational institution at which the student is enrolled, less other financial assistance available to the student for application to such costs.
I also certify the student is enrolled at least half-time in a degree granting program and that I have been informed that a certification by the applicable educational institution that the student is maintaining "satisfactory academic progress" as defined by such institution is a condition to MEFA's approval of this loan.

By clicking the "Agree and Submit" button below, I consent to the use of an electronic signature to manifest my agreement to the terms and conditions set forth in this application and confirm the statements, representations and certifications attributed to me above. I consent and agree that my use of a key pad, mouse or other device to select the "Agree and Submit" button constitutes my signature, acceptance and agreement as if I had actually signed in writing, that no certification authority or other third party verification is necessary to validate my electronic signature; and that the lack of such certification or third party verification will not in any way affect the enforceability of my signature or of the terms and conditions set forth in this application or the attribution to me of the statements, representations and certifications I have made above.

I understand and agree that my signature executed in conjunction with my electronic submission of this application shall be legally binding.

I understand that:

if I do not wish to consent to the use of an electronic signature or the electronic acceptance of the terms and conditions of this application, I may refrain from pressing the "Agree and Submit" button below, in which case this application will be considered incomplete and will not be processed.
if this application is a joint application with other individuals, it will not be considered complete until each co-applicant has separately entered the information required as to such co-applicant and has submitted such information.

I hereby accept and agree to the sharing of information I have provided under the circumstances and for the purposes described in MEFA's privacy policy. I authorize MEFA or its designee to check my credit references and to obtain a credit report. I also authorize MEFA to provide credit information arising from this transaction to others as necessary or appropriate in connection with its evaluation of this application and as otherwise permitted under applicable law, and to review my credit eligibility for all MEFA loan products, and understand and agree that MEFA may offer me any loan product(s) for which it determines I am or may be eligible. I understand and acknowledge that this loan may appear on my personal credit report. I, the student, and, if I am the student's parent, I, the student's parent, also authorize the release by any educational institution the student may attend to MEFA, or any subsequent holder, of any information pertinent to this loan (e.g., employment, enrollment status, current address).

By clicking the "Agree and Submit" button below, I consent to receive electronic mail (email) and online communications and disclosures regarding this application, the loan for which I am applying, my loan account if MEFA provides a loan in response to this application and all other communications and disclosures from MEFA to me, whether related or unrelated to this application or any such loan, instead of receiving such communications by regular postal mail (all such communications, "Communications"). My consent to receive Communications electronically includes, but is not limited to, transmittals of or regarding all applications, loan agreements, disclosures, notices, and other records MEFA or any contractor or agent of MEFA provides to me or that I sign or submit or agree to at the request of MEFA or any contractor or agent of MEFA. I understand and agree that I may receive notifications that my loan is delinquent by electronic mail or regular postal mail, at MEFA's sole election, and that this notification will include information about how to cure the delinquency and avoid negative credit furnishing and the potential loss of cosigner release eligibility (if applicable). I understand and agree that this consent may cover information that MEFA is required by law to provide to me in writing.

By clicking the "Agree and Submit" button below, I acknowledge and agree that I may print a paper copy of any Communication from my computer, and agree to keep MEFA informed of any changes in my telephone number, mailing address, or email address. I understand that I may contact MEFA to tell it about these changes by email at mefaloans@mefa.org or by phone at (800) 266-0243. I also acknowledge my understanding that I have the right to withdraw my consent to receive/obtain electronic Communications by email at mefaloans@mefa.org or by phone at (800) 266-0243.

By clicking the "Agree and Submit" button, I authorize MEFA and its affiliates and agents to contact me regarding my education loan application and any subsequent loan, including but not limited to repayment of my loan, at the current and any future numbers that I provide for my telephone, including cellular (mobile) telephone, or other device using an automatic dialing systems, prerecorded voice messages and/or SMS text messages. I also authorize MEFA's service providers, and agents to contact me using these methods.

	I am not married.
	The borrower on this application is my spouse.
	I am married, however the borrower on this application is not my spouse. I understand that my spouse must sign the MEFA Loan Agreement before any funds can be disbursed.

Online Application

Current Address

Current Address

West Virginia Notice to Cosigner

Residence

Current Employment

Previous Employment

Residence

Current Employment

Previous Employment

Spouse's Contact Information

Current Address

Spouse's Contact Information

Current Address