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Freedom Repair
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Book an Appointment
Contract
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Apply Now
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First Name
*
Last Name
*
Email
*
How did you hear about us?
*
Please Select
Google
Email
Phone Number
*
Date of birth
*
Address
*
Layout
City
*
Zip
*
State
*
Country
Canada
United States
Indonesia
Pakistan
Nigeria
Brazil
Bangladesh
Russia
Mexico
Ethiopia
Japan
Philippines
Egypt
DR Congo
Vietnam
Iran
Turkey
Germany
Thailand
United Kingdom
Tanzania
France
South Africa
Italy
Kenya
Myanmar
Colombia
South Korea
Uganda
Sudan
Spain
Argentina
Algeria
Iraq
Afghanistan
Poland
China
Morocco
Saudi Arabia
Ukraine
Angola
Uzbekistan
Yemen
Malaysia
Ghana
Mozambique
Nepal
Madagascar
Next
Occupation (E.I, Aish, self employment can also apply)
Employer name
gross monthly income
Next
Do you have collections?
*
please select
yes
no
Are you in a bankruptcy
*
Please Select
Yes
No
Are you in a consumer proposal?
*
Please Select
Yes
No
what are you looking for?
*
loan
Credit card
vehicle loan
What bank do you deal with?
*
How long have you been with your bank?
*
Will you be using this bank to pay for your credit card and subscription payments?
*
yes
no
Next
Institution number (3 digits)
*
Transit number (5 digits)
*
Account number (7-12 digits)
*
I agree by checking this box to Freedom Repair Specialists terms/ contract
*
click here
Member Contract
please sign your name below with your Signature
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