Credit Application
First Name:
Last Name:
Address:
City:
State:
Choose a State
Outside US / Canada
Alabama
Alaska
Alberta
American Samoa
Arizona
Arkansas
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
British Columbia
California
Colorado
Connecticut
Delaware
District Of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Manitoba
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Brunswick
New Hampshire
New Jersey
New Mexico
New York
Newfoundland
North Carolina
North Dakota
Northern Mariana Is
Northwest Territories
Nova Scotia
Ohio
Oklahoma
Ontario
Oregon
Palau
Pennsylvania
Prince Edward Island
Province du Quebec
Puerto Rico
Rhode Island
Saskatchewan
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virgin Islands
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Yukon Territory
Zip Code:
Own
Rent
Years at Residence:
Monthly Payment:
Home Phone:
Email Address:
Social Security #:
Birthdate:
Month:
Day:
Year:
Employer:
Years:
Monthly Income:
Business Phone:
Make / Model /Year:
Comments:
Copyright - Prescott Valley Motorcycles
Click to See Our Victory Motorcycles
Click to See Our APC Custom Bikes
Click to See Our Lehman Trikes
Click to See Our Harley-Davidson Bikes
Prescott Valley Motorcycles
6500 E HWY 69
Prescott Valley, AZ 86314
info@pvmotorcycles.com
928-772-4266
888-870-9369
Mon - Sat: 9AM - 6PM