Visa ScoreCard Rewards Card

Visa ScoreCard Rewards Card

Apply Online - It's Safe, Secure & Easy

To begin, please fill out the fields in the form below. One of our representatives will contact you within one business day to complete the process.

This form uses 256 bit SSL encryption, ensuring that no one else will see your personal information while it is in transit. Please view our Privacy Policy for more information.

Resident within a 100-mile radius of Dubuque, Dyersville, or West Des Moines, Iowa only please.

Patriot Act

Important Information About Procedures for Opening a New Account. To help the government fight the funding of terrorism and money laundering activities, Federal law requires all financial institutions to obtain, verify, and record information that identifies each person who opens an account. What this means for you: When you open an account, we will ask you for your name, address, date of birth, and other information that will allow us to identify you. We may also ask to see your driver's license or other identifying documents.

There is a 20 minute time limit on this application.

  • OK Which credit card are you applying for today? is required

Branch Information:

  • OK Please select the branch location you wish to work with to complete the new account process: is required

 

  • Are you a new customer?

    OK Are you a new customer? is required

 

  • OK Amount Requested: is required

Personal Information:

  • OK Name is required
  • Social Security Number

    - -
    OK Social Security Number is required
  • Date of Birth

    OK Date of Birth is required
  • Home Phone

    - -
    OK Home Phone is required
  • Daytime Phone

    - -
    Optional OK Daytime Phone is required
  • OK Email is required

Address Information:

  • OK Residential Address (Not a P.O. Box) is required
  • OK City is required
  • OK State is required
  • OK Zip is required
  • Use residential address for mailing address

    OK Use residential address for mailing address is required
  • Years At Home Address

    OK Years At Home Address is required
  • Do you:

    OK Do you: is required

Dependent and Relative Information:

  • OK Number of Dependents is required
  • OK Age of Dependents is required
  • OK Name of Nearest Relative (Not living with you) is required
  • OK Relationship of Relative is required
  • OK Relative Address (Not a P.O. Box) is required
  • OK Relative City is required
  • OK Relative State is required
  • OK Relative Zip is required
  • Relative Phone Number

    - -
    OK Relative Phone Number is required

Employment Information:

  • OK Employer's Name is required
  • Employer Phone

    - -
    OK Employer Phone is required
  • OK Your Position is required
  • OK Gross Monthly Household Income* is required
  • Years at Company:

    OK Years at Company: is required
  • *If you are 21 are older, you may include income from others that you can reasonably access to pay bills.

    *Federal law requires that we collect income information to determine your ability to repay.

Previous Employer:

  • OK Employer's Name is required
  • Employer Phone

    - -
    OK Employer Phone is required
  • OK Your Position is required
  • OK Gross Monthly Household Income is required
  • OK Years at Previous Company: is required

Other Income Sources:

    Alimony, child support, or seperate maintenance income need not be revealed if you do not wish to have it considered as a basis for repaying this obligation.

  • Alimony, child support, seperate maintenance income received under:

    OK Alimony, child support, seperate maintenance income received under: is required
  • OK Sources of Other Income is required
  • OK Amount Per Month is required
  • Is any income listed in this Section likely to be reduced before the credit request is paid off?

    OK Is any income listed in this Section likely to be reduced before the credit request is paid off? is required
  • Have you previously received credit from us?

    OK Have you previously received credit from us? is required

 

  • Number of Joint Owners on this Account

    Optional OK Number of Joint Owners on this Account is required

Joint Applicant #1:

  • OK Relationship to Primary Applicant is required
  • OK Name is required
  • Date of Birth

    OK Date of Birth is required
  • Social Security Number

    - -
    OK Social Security Number is required
  • Home Phone

    - -
    OK Home Phone is required
  • OK Employer is required
  • Work Phone

    - -
    OK Work Phone is required
  • OK Annual Income is required

Joint Applicant #1 - Current Address

    OK Different from Borrower 1 address. is required
  • OK Residential Address is required
  • OK City is required
  • OK State is required
  • OK Zip is required

Joint Applicant #2:

  • OK Relationship to Primary Applicant is required
  • OK Name is required
  • Date of Birth

    OK Date of Birth is required
  • Social Security Number

    - -
    OK Social Security Number is required
  • Home Phone

    - -
    OK Home Phone is required
  • OK Employer is required
  • Work Phone

    - -
    OK Work Phone is required
  • OK Annual Income is required

Joint Applicant #2 - Current Address:

    OK Different from Borrower 1 address. is required
  • OK Residential Address is required
  • OK City is required
  • OK State is required
  • OK Zip is required

 

  • Please enter any additional information you would like us to know... OK Comments is required

Terms & Conditions:

    Visa Classic Card Terms & Conditions

    OK I have read and agree to the above Terms & Conditions is required

Terms & Conditions:

    Visa Gold Card Terms & Conditions

    OK I have read and agree to the above Terms & Conditions is required

Terms & Conditions:

    AmeriClub Visa Gold Card Terms & Conditions

    OK I have read and agree to the above Terms & Conditions is required

Terms & Conditions:

    Visa ScoreCard Rewards Gold Card Terms & Conditions

    OK I have read and agree to the above Terms & Conditions is required

Terms & Conditions:

    Visa Affinity Card - Loras College Terms & Conditions

    OK I have read and agree to the above Terms & Conditions is required

Security Code:

  • OK is required

 

    American Trust & Savings Bank reserves the right to use the above information to obtain verifications of identity and background before opening any accounts. We may also access information about you from a consumer reporting agency, such as a copy of your credit report, before opening any account. By submitting this form, I/we grant full permission to do so.

  • This document is being secured using SSL encryption provided by your browser. Your information will be encrypted when using this form while in transit between your browser and American Trust & Savings Bank.