AlkaViva Finance Application

Get started on the road to clean and great tasting alkaline, ionized water ownership! Fill out the easy online application below and click "I Accept" to submit. We will notify you within one business day with your options.

• You can also fax your application to (775) 201-1188 or scan and email to financing@alkaviva.com. Print the financing application.
• We will contact you with your credit decision within one business day.
• This form must be filled out completely in order for your application to be valid.

All information submitted remains strictly confidential.

The form encrypts all of the information and transmits it via a secure SSL server with a valid SSL Security Certificate.

Electronic Signature Agreement (ESA) You agree that by entering your initials and selecting the "I Accept" button below constitutes your electronic signature and is the legal equivalent of your manual signature and is your specific authorization and consent for AlkaViva to run your credit report. You also agree that no certification authority or other third party verification is necessary to validate your E-signature and that the lack of such will not in any way affect the validity of your consent or the enforceability of your E-signature.