BPI CREDIT CARD APPLICATION CONFIRMATION FORM

This is to confirm that I have submitted a physical copy of my credit card application form, and have submitted a
copy of the following documents as part of the application requirements:
1. ID, please specify type: ___________________________________________
2. Income document, please specify if applicable: ___________________________________________
___________________________________________

Also, I confirm that the following items were clearly explained and discussed to me by the sales agent whose name
and agency affiliation appears below:
YES NO
1. Features and benefits of my chosen card/s. (Please check)
 BPI Blue MasterCard  BPI Edge MasterCard
 BPI Gold MasterCard  Visa Signature
 Amore Visa Regular  eCredit Mastercard
 Amore Visa Platinum  BPI Family Savings Banks
 BPI-Petron MasterCard MasterCard
2. Annual membership fee is free only for the first year
3. The agent offered ONLY a BPI and/or BPI Family Credit Card product.

____________________________________ ____________________________________
Customer’s Name and Signature Direct Sales Agent and Signature

____________________________________ ____________________________________
Location / Date Agency Name

BPI CREDIT CARD APPLICATION CONFIRMATION FORM

This is to confirm that I have submitted a physical copy of my credit card application form, and have submitted a
copy of the following documents as part of the application requirements:
1. ID, please specify type: ___________________________________________
2. Income document, please specify if applicable: ___________________________________________
___________________________________________

Also, I confirm that the following items were clearly explained and discussed to me by the sales agent whose name
and agency affiliation appears below:
YES NO
1. Features and benefits of my chosen card/s. (Please check)
 BPI Blue MasterCard  BPI Edge MasterCard
 BPI Gold MasterCard  Visa Signature
 Amore Visa Regular  eCredit Mastercard
 Amore Visa Platinum  BPI Family Savings Banks
 BPI-Petron MasterCard MasterCard
2. Annual membership fee is free only for the first year
3. The agent offered ONLY a BPI and/or BPI Family Credit Card product.

____________________________________ ____________________________________
Customer’s Name and Signature Direct Sales Agent and Signature

____________________________________ ____________________________________
Location / Date Agency Name