CLOU-LOAN
Application Form
Your Name:
*
First Name
Last Name
Address:
*
Email Address:
*
Date Of Birth
*
-
Month
-
Day
Year
Phone Number
*
NIN
*
BVN
*
Loan Amount
*
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EMPLOYMENT STATUS
Employment Status
*
Employed
Self-Employed
Civil Servant
Un-Employed
Company Name:
*
Company Address:
*
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NEXT OF KIN
Name of Next of Kin
*
First Name
Last Name
Relationship
*
Father
Mother
Sister
Brother
Uncle
Aunty
Other
Specify Relationship
*
Phone Number
*
Email Address:
*
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GUARANTOR 1
Guarantor 1
*
First Name
Last Name
Guarantor 1 Address:
*
Email Address:
*
BVN
*
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GUARANTOR 2
Guarantor 2
*
First Name
Last Name
Guarantor 2 Address:
*
Email Address:
*
BVN
*
*
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