Application Form | Stargate

Apply for a loan

To register, please take the time to fill out the information below. To make the application process quicker please have all your documentation ready

Please complete fields with *

Title

Middle Name

Last Name

Date of Birth

Personal Details

First Name

Gender

NRC/Passport/Drivers License Number

Marital Status

Is your spouse employed

Employer of your spouse

Salary/Income

Loan Type

Loan Purpose

Loan Amount Requested

Loan Tenor (Months)

Maximum Deduction Wanted

Loan Details

Current Credit Commitments (Please indicate the name of the lender, date obtained, term, balance and whether your commitment has been refinanced)

Mobile Phone Number

Contact Details

Address

Alternative Phone Number

Next of Kin

Next of Kin Mobile Number

Next of Kin NRC

Relationship

Next of Kin Details

Name of Employer

Address

Job Title

Employee/Man Number

Employment Status

Contract Expiry Date

Employer Landline

Employer Mobile

Employer Details

How did you hear about us?

Account Holder Name

Bank Name

Account Number

Branch Name/No.

Account Type

Account Opened Date