MilesAway Express Request

Please fill in the information below. Information is required unless noted as optional. When finished, click the "Submit" button at the bottom of the page.

All fields marked with * are required.

Please tell us about yourself.

First Name: *

Middle Initial (Optional):

Last Name: *

Social Security Number: *

Date of Birth: *

Home Address: *

P.O. Box, Apt., Ste., etc. (Optional):

City: *

State: *

(This Program is not available in Puerto Rico, Guam or Virgin Islands.)

ZIP: *

Phone: *

Please tell us about your practice/business.

Practice/Business Name: *

Practice/Business Address: *

P.O. Box, Apt., Ste., etc. (Optional):

City: *

State: *

ZIP: *

Practice/Business Phone: *

Practice/Business Fax (Optional):

E-Mail: *

Do you own your practice/business? *

Yes No

Specialty (Optional):

Please provide us with some financial information.

Net Annual Income ($): *

Business Card Options

Select Your Business Card: *

Business Classic • 0% APR for 6 months, then Prime + 9.99% • 1 point per $ spent • Points expire after 3 years • No annual fee • 10,000 bonus points after first use
Business Preferred • 0% APR for 6 months, then Prime + 9.99% • 1.5 points per $ spent • No expiration on points • $75 annual fee (waived after spending $3k in anniversary year) • 10,000 bonus points after first use

Include business name on card (Optional)

Authorizations and Disclosures

By submitting this request, I certify that I have read, met and agreed to all of the terms, conditions and disclosures below.

IMPORTANT INFORMATION REGARDING YOUR APPLICATION

MilesAway Visa Signature Terms, Conditions and Disclosures

Annual Fee

The annual membership fees that apply for each MilesAway Card type are as follows:

MilesAway Classic: No annual fee
MilesAway Preferred: $75 annual fee; however, the annual fee will be waived if you have at least $3,000 in Purchases during a year (a year is calculated as the 12 month period that begins on the anniversary date of opening your account).

Periodic Rate of Finance Charge

The Periodic Rate on portions of your Account will be determined in accordance with either a fixed rate plan or a variable rate plan, depending on the MilesAway Card type. Introductory Rates may be used from time to time. The “Periodic Rate” for any given billing cycle shall be calculated in accordance with the following formula: (Annual Percentage Rate/365) x (Number of days in billing cycle) = Periodic Rate. For complete details on the Periodic Rate of Finance Charge click here (PDF).

Grace Period on Purchases

25 calendar days.

Minimum Finance Charge

$.50

Transaction Fees

Cash Advance - 3% of the transaction amount (minimum $10).
Over the Credit Limit Fee - $25.
Return Payment Fee - $25 (except in Maryland).
Late Payment Fee - $25.
Alternative Payment Method - $10 for any payment you make via the Automated Response Unit. $15 fee for phone payment with a customer service representative.
Balance Transfer Fee - 3% of the amount of the Balance Transfer (minimum $10, maximum $75).

Note: These terms and conditions are current as of February 2023. If you have any questions, please call 1-800-503-0954, option 2 for assistance.

By signing the application, I/we:(1) request that NCMIC Finance Corporation (herein “NCMIC”), the card issuer, establish a MilesAway business credit card account for me and/or my company and issue one or more cards to be used in connection with the account; (2) understand this application is given for the purpose of obtaining credit and is subject to approval; (3) authorize NCMIC or its designees to investigate my personal and/or business creditworthiness by obtaining reports from credit reporting agencies and other information and credit records and to share such information regarding the account with credit reporting agencies, other creditors of my business, and third parties that NCMIC reasonably believes are conducting credit inquiries in accordance with applicable law; (4) authorize NCMIC to order a credit report in connection with the administration, review, or collection of the account and in connection with offering additional products and services to me; (5) authorize past and present lenders, lessors, landlords, and other creditors to provide NCMIC and its designees with any and all information that will assist in the credit inquiry; and (6) certify that all information provided in this application is true and correct.

I/we agree that, if a credit card account is opened in response to this application: (1) the account and the card(s) shall be governed by the terms and conditions of the Cardholder Agreement provided to me when the card(s) are issued, as it may be amended from time to time; (2) I’m/we’re personally liable for all charges, advances, and fees made or incurred under the account by my company or anyone authorized or permitted by my company to use the account and/or the card(s); (3) the account shall be used only for business or commercial purposes; (4) the credit line and the terms of my account will be based on a review of the information provided in this application, the current credit report, and any other information bearing on creditworthiness; and (5) any dispute arising under or related to the account or the card(s) shall be adjudicated in the federal or state court located in Polk County, Iowa.

Notice: The Federal Equal Credit Opportunity Act prohibits creditors from discriminating against credit applicants on the basis of race, color, religion, national origin, sex, marital status, age (provided the applicant has the capacity to enter into a binding contract); because all or part of the applicant’s income derives from any public assistance program; or because the applicant has, in good faith, exercised any right under the Consumer Credit Protection Act. The federal agency that administers compliance with the law concerning this credit is the Federal Trade Commission, Equal Credit Opportunity, Washington, DC 20580. If your application for business credit is denied, you have the right to a written statement of the specific reasons for the denial. To obtain the statement, please contact: The MilesAway Program, 14001 University Avenue, Clive, Iowa 50325-8258 within 60 days from the date you are notified of our decision. We will send you a written statement of the reasons for the denial within 30 days of receiving your request for the statement.

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 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.

Loans made or arranged pursuant to a California Finance Lenders Law license. New York residents may contact the New York state department of financial services by telephone at (800) 342-3736 or visit its website (https://www.dfs.ny.gov/) for free information on comparative credit card rates, fees and grace periods.

Terms, conditions and disclaimers

* I have read all Authorizations and Disclosures and:

I accept