EMV Pay Later Application

Eagle Mountain Volleyball now offers the ability to pay your club fees over time with our new Pay Later Installment Program, powered by Rev19! Through this program, we are able to offer competitive financing, allowing you to pay in 3, 6, 9 or 12 month increments. See details and Installment Loan Application below.

Installment Loan Application

Please fill out all sections below to complete your installment plan application, including acceptance of our Terms & Conditions at the bottom of the form. Once you have submitted your form, approval status of your application will be emailed to you as soon as possible.
Player Information
Player Name*
Please enter the player's name for which you are paying club dues.
Requested Installment Loan Amount
Enter Requested Dollar Amount for Installment Loan*
Enter Total Amount You Would Like to Finance ($300 Min - $10,000 Max)
Please enter a number from 300 to 10000.
Application Date*
Enter today's date.
Date Format: MM slash DD slash YYYY
Installment Plan Options
We offer the ability to pay your dues over 3, 6, 9 or 12 months. The below table illustrates monthly payments associated with your total loan amount and number of installments chosen. The APR for Pay Later installment loans is 19.9%. For the 3, 6 and 9 month installment options, the first month is interest free, and for the 12 month option, the first two months are interest free. See Terms & Conditions for complete details.
Choose Installment Plan*
For the 3, 6 and 9 month installment options, the first month is INTEREST FREE. For 12 month plans, the first two months are INTEREST FREE.
- 3 installments
- 6 installments
- 9 installments
- 12 installments
Installment Payment Date*
Enter your desired day of the month for your installment payments to be drafted from your bank account.
Customer Contact Details
Name*
First Last
Address*
Street Address Address Line 2 City State ZIP Code
Customer Identification
Valid Driver's License Number*
State of Issue*
Social Security Number*
Email Address*
Date of Birth*
I consent to credit check*
- Yes
Customer Bank Details
Please enter details of the bank account from which the customer's installments are to be debited.
Name of the Account Holder*
Enter your full name as it appears on your bank statement.
Account Number*
Enter account number of the checking or savings account to be debited.
Routing Number*
Enter the 9 digit ABA Routing Number for your Bank
Installment Loan Terms & Conditions
CLICK HERE to view our Terms & Conditions related to your Pay Later Installment Loan. You must check the box below and provide your signature that you agree to the Terms & Conditions before your application can be submitted.
I accept the Terms & Conditions*
- Yes
Signature*
Please sign this form by typing your full name.

EMV Pay Later Application

Installment Loan Application

Player Information

Requested Installment Loan Amount

Installment Plan Options

Customer Contact Details

Customer Identification

Customer Bank Details

Installment Loan Terms & Conditions