Application for Credit
This form will take you approximately 15 minutes to complete. You will be asked for your personal and banking details as well as the method that you wish to pay your account with

product selection
I am applying for a
WW Store Card WW Credit Card WW Personal Loan
Woolworths Financial Services (Pty) Ltd (Registration number 2000/00932/07) is an authorised financial services and registered credit provider - NCRCP-49
Did you apply for debt counselling or are you under debt counselling?
Yes No
about you
Full name  
South African ID Number  
Gender   Male Female
Language for quote, pre-agreement and terms & conditions   English Afrikaans seSotho isiZulu
Language of choice   English Afrikaans
Date of birth  
Country of Residence  
Marital Status  
Number of children under 18  
where you live
Home address  
(not a box number)  
Postal code  
postal address is the same as home address?
Postal address  
Postal code  
Home telephone   
Cellphone number   
Are you  
where you work
Name of Employer [exclude brackets i.e. ( )]  
Industry Type  
Postal code  
Job title  
Job status  
Staff/Clock number  
Work telephone   
Switchboard number   
How many years/months have you worked there?   Year(s) Month(s)
How long with your previous employer?   Year(s) Month(s)
your finances [exclude cents i.e. R2000 not R2000.35]
Gross monthly salary   R
Other income   R
Maintenance cost (child maintenance)   R
Municipal cost (water, electricity, rates)   R
All Other Expenses (excluding credit instalments)   R
friend or relative information - not living with you
This information is confidential and will not be used for marketing purposes.
Full name  
Home telephone     
Work telephone     
Cellphone number     
debit order authorisation (your details)
Please fill in this section if you are applying for a Personal Loan.
Would you like to pay your Woolworths account by debit order? Yes No
If so, please specify bank name:  
Type of account:  
Cheque/Current Transmission/Savings
Bank account number:  
Branch code:  
Would you like to pay:   Minimum Monthly Payment
Full Amount
about your loan (please make sure that you fill in all of this section if you are applying for a loan)
Amount you require (R1000-R30000)
balance protection insurance (covers death, retrenchment, critical illness - terms & conditions apply)
Would you like balance protection insurance? Yes No
the MySchool MyVillage MyPlanet programme
Would you like to become a supporter? Yes  No   
If you are already a supporter, please provide your current 16 digit MySchool Card No.
permissions & sharing of information
My home language is English IsiNdebele IsiZulu Sesotho SiSwati
Xitsonga Afrikaans IsiXhosa Northern Sotho
Setswana Tshivenda
I would like my credit limit to be reviewed each year for the product I am applying for and for this I agree to a credit assessment
I do not want Woolworths Financial Services to share my personal information with anyone else
I do not want you to tell me about any exciting promotions or offer me opportunities by:
I confirm that:
  1. All the details I have given on this application form are correct.
  2. If I am married in community of property, I have the written consent of my spouse to enter this agreement.
  3. I have read, understood and will comply with the terms and conditions of the agreement this application form relates to (Store Card, Credit Card or Personal Loan).
  4. I will pay any amounts I owe to Woolworths Financial Services when asked to do so.
  5. Woolworths Financial Services may:
    • Monitor all my information, instructions and transactions relating to this agreement continuously.
    • Contact any credit bureau, the South African Fraud Prevention Services and any other person I deal with to get and share information about my credit profile and payment history.
    • Report any incorrect information I have given to the South African Fraud Prevention Services. The report may be viewed by subscribers to the South African Fraud Prevention Services.
I hereby also confirm that all details supplied above are correct and true. I acknowledge that I have read and understood the terms & conditions for the product that I am applying for. I will abide by the terms and conditions governing the Woolworths product (Store Card, Personal Loan or Credit Card) that I am applying for and undertake to pay my indebtedness to Woolworths as and when required.
If I am married in community of property, I hereby warrant that I have obtained the written consent from my spouse/partner to conclude this credit agreement.