Rogers & Hollands Jewelers and Ashcroft & Oak Jewelers

Online Application

Credit Disclaimer

APPLICANT: Please read the following before completing this form: (1) Applicant represents that the information given in this Application is complete and accurate and authorizes us to check with credit reporting agencies, credit references and other sources disclosed herein in investigating the information given; (2) Applicant requests a Credit Card if it is our practice to provide one; (3) Married applicants may apply for an individual account; (4) Applicant represents that this Account will only be used for personal, family or household purposes; **(5) Sale Amount-this figure does not represent the amount of credit applied for; it reflects purchase price of merchandise only.

YOU WILL NEED TO READ AND SIGN THE AGREEMENT BEFORE SUBMITTING YOUR APPLICATION.


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