Today s Dreamers, Tomorrow s Leaders Edge Business School Student Loan Application Second semester 2015 1 P a g e S t u d e n t L o a n A p p l i c a t i o n F o r m
Dear Applicant We have received your request for an Edge Business School Loan for 2015 and have pleasure enclosing an application form. When completing the form, please take note of the following: Read the instructions carefully Send the completed form, together with the required documents to apply@ebs.co.za Applications that are not 100% complete will not be considered. Please ensure that all requested documents are attached Please initial every page and sign at the end of your application in the space provided All information will be kept confidential 1. Checklist Please tick on Yes if you have included a certified copy of the specific document. (Your application will not be considered without the relevant documentary proof, as applicable). Yes 1. South African ID 2. Proof of address recent utility bill showing residential address 3. Payslips of the person (3 months) 4. Bank statements of 3 months stamped by the bank 5. If self-employed, a confirmation of earnings from a registered auditor 2 P a g e S t u d e n t L o a n A p p l i c a t i o n F o r m
Student loan application form Please mark answer with a Section 1: Personal Information of the student Identity number Are you a South African Citizen? Yes No Surname First names Date of Birth Day Month Year Gender Female Male Population group: African Coloured Indian White Do you suffer from any disability? No Yes If yes, please specify the nature of your disability: *Gender, population group and disability information required for statistical purposes Cell number Alternative Cell number Home number Email address Postal Address Physical Address Section 2: Details of person responsible for the loan Identity number Are you a South African Citizen? Yes No Surname First names Date of Birth Day Month Year Gender Female Male Alternate Cell Number Home number Email address Postal address Physical address Relation to the applicant 3 P a g e S t u d e n t L o a n A p p l i c a t i o n F o r m
Section 3: Employment details Income category Salary earner Contract worker Student Other Present employer Occupation Employed since Number of years at previous employer Work telephone number Work physical address Section 4: Academic details Student status Part time Year of study Expected final year Full time Section 5: Loan Details Total loan amount required: Total for the year Tuition fees R Do you wish to pay the initiation fee upfront or do you wish to include it in the loan? Upfront Include in loan Section 6: Banking details Bank Branch Type of account Branch code Account number Section 7: Payment history Are you currently under or have you applied for debt review? Yes No Do you have any dispute in progress with a credit bureau? Yes No Are you under administration? Yes No Do you have any rearrangement in place with a credit Yes No provider as a result of debt counselling? Do you have curator bonis? Yes No If married in community of property, is your spouse currently Yes No under debt review or has he/she ever applied for debt review? Section 8: Financial information of the person who is responsible for the loan 4 P a g e S t u d e n t L o a n A p p l i c a t i o n F o r m
If the applicant is a full time student the income and expenditure table must be completed by the surety. If the applicant is a part time student without surety and is employed, the income and expenditure table must be completed by the applicant. Gross salary R Less Deductions PAYE UIF Other please state below Net salary after deductions R Living expenses Rent/Bond repayment Cell phone Food Clothing accounts Car repayments Loan and credit card payments Insurances Retirement savings Petrol/Transport Other Expenses (please specify) Nett Surplus R I hereby warrant that I/we have fully and trustfully answered all your questions and responded to requested information as part of this assessment period. I/we hereby confirm that I/we have fully disclosed my/our debt repayment. I/we consent to Edge Business School making enquires about my/our credit record with credit reference agencies for the purpose of assessing the application or updating my/our information in the future. I/we further consent to the Edge Business School sharing information about how I/we manage this credit agreement with such agencies, who may in turn share this information with other credit providers. I/we consent to identify any fraud prevention checks and sharing information relating to this application through the South African Fraud Prevention Services. 5 P a g e S t u d e n t L o a n A p p l i c a t i o n F o r m
Signed at (place) on (date) By student (full name) Signature By surety (full name) Signature By Witness (full name) Signature 6 P a g e S t u d e n t L o a n A p p l i c a t i o n F o r m