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    Chema Chema Individual App Form

    Uploaded by

    kgotsoprincekebaetse

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    Chema Chema Individual App Form

    Uploaded by

    kgotsoprincekebaetse
    130 views2 pages

    Original Title

    Chema Chema Individual App Form (1)

    Copyright

    © © All Rights Reserved

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    PDF, TXT or read online from Scribd

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    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    130 views2 pages

    Chema Chema Individual App Form

    Uploaded by

    kgotsoprincekebaetse

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    You are on page 1of 2

    INDIVIDUAL LOAN

    APPLICATION FORM

    1. Business Details
    Business Name
    Type of Business
    Business Location
    Business Status (tick the correct) Start-up: Existing:
    Loan Amount (BWP)
    Is the business LEA registered? Yes No Registration number:

    2. Personal Details
    Title Mr. Mrs. Miss. Dr. Other
    Surname
    Other Names
    Omang No:
    Date of Birth:
    Contacts: Cell Phone: Telephone:
    Email Address:
    Marital Status: (Tick the correct) Married: Single: Divorced: Widow:
    Marriage Regime In Community: Out of Community:
    Disability Yes: No:
    Postal Address:
    Physical Address
    Home Village Details District: Village:
    Ward: Constituency:
    Are you employed? (Tick the correct) Yes No
    If yes Name of employer:
    Contact Details: Salary (per month):

    3. Next of Kin Details


    Name: Name:
    Relationship: Relationship:
    Omang No: Omang No:
    Postal Address Postal Address
    Physical Address Physical Address

    Cell Phone No: Cell Phone No:

    Chema Chema Loan Application Form | Page 01


    4. Project Description:
    (Give a brief description of the project and how you conduct business operations and where do you see new business opportunities)

    Actuals Projections
    1. State business monthly sales
    2. State business monthly costs
    3. State business expenses
    4. State business profit

    5. Loan Facility Details


    Loan breakdown (Stock, Tools/ equipment, packaging material, transport etc)
    Items/ Description Quantities Total Loan Amount

    6. Commercial Bankers/ Mobile Wallet Details


    Bank Name Branch
    Account Number
    Account type (savings/ current, Business etc.)
    Telephone
    Mobile Wallet Provider Mobile Wallet Number

    7. Have you ever benefited from any other Government Funding/ Grant (YES/ NO)
    IF YES (Explain)

    Chema Chema Loan Application Form | Page 02

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