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Vacancy
Open An Account
Branch
Home
About Us
Services
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News
More
Forms
Contact
FAQs
Vacancy
Contact Info
Gotera Agona Cinima, next to St. Yared Church
Info@africavillagemicrofinance.com
+251 11 437 6511
Open An Account
Loan Application Form
Home
Loan Application Form
First Name
*
Father Name
*
Grandfather Name
*
Sex
*
Male
Female
Age(18+)
*
City
*
Addis Ababa
Adama
Bahirdar
Gondar
Dire Dawa
Mekelle
Hawassa
Woreda
*
Zone
*
Special Name of The Settlement
*
House Number
*
Residential ID Number
*
Phone Number Residential
*
Mobile Phone Number
Customer Business License
*
Date of The Issuance of Business License
Level of education
Average Monthly Payment
Marriage status
*
Single
Married
Divorced
Widow
Home Situation
*
Private
Rental
Water
*
Private
Common
Electricity
*
Private
Common
Family monthly income
From Salary
*
ETB
From Business
*
ETB
Other Income
*
ETB
Total Monthly Income in Birr
*
ETB
customer's work/employment information
Job Title
*
Job Sector
*
Work Type
Temporary
Permanent
Type Of Job
*
Full-time
Par-time
Temporary
Employee
Contruct
Intern
Client Workspace?
Doesn't has it
Street Trade
Private
Rental
Others
Time Spent On job
*
Loan Information
Requested loan amount
*
ETB
Purpose of the loan
*
Loan Cycle
*
Month
*
Day
*
Year
*
Loan Expiry Date in Months
*
Do you borrowed from other lending institutions before?
*
Yes
No
Do you have a loan from another individual or organization?
*
Yes
No
Full information and type of the collateral provided by the customer for the requested loan amount
*
Agree
*
I confirm with my signature that the above information is correct.
Signature
*
Date
*
Submit
