Secure Application

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Simple Financing

Everyone deserves clean water. We offer flexible plans to fit your budget. Fill out this secure form to see your options.
* All fields are required to process your pre-qualification.

Personal Information

Full Name

Date of Birth

SSN (Encrypted)

Email Address

Phone Number

Home Address

Street Address

City

State

Zip Code

Loan & Project Details

Annual Household Income

Employment Status

Estimated Loan Amount needed

System Interest

Texas Legal Disclosures & Terms

NOTICE OF CANCELLATION

YOU, THE BUYER, MAY CANCEL THIS TRANSACTION AT ANY TIME PRIOR TO MIDNIGHT OF THE THIRD BUSINESS DAY AFTER THE DATE OF THIS TRANSACTION.

IMPORTANT NOTICE:

By submitting this application, you authorize Continental Home Solutions to obtain a consumer credit report for the purpose of evaluating your creditworthiness in connection with your application for credit.

You acknowledge receipt of the "Notice of Right to Cancel" which explains your right to cancel this transaction within three business days. We want you to be 100% comfortable with your decision.

CONSENT TO ELECTRONIC COMMUNICATION:

By checking the box below, you agree to receive communications, disclosures, and notices electronically.

I have read and agree to the Terms, Authorization for Credit Check, and acknowledge receipt of the Notice of Right to Cancel (3-Day Return Policy).

By submitting this form, you agree to allow Continental Home Solutions to process your data for financing pre-qualification purposes.