Document 6568330

MINISTRY OF EDUCATION, SCIENCE &
TECHNOLOGY
PRIVATE BAG 328
CAPITAL CITY
LILONGWE 3
Affix one colour passport size photo
STUDENTS LOAN APPLICATION FORM
CAUTION
Any student who knowingly makes a false statement whether orally or in writing relating
to any matter affecting the application for a Loan shall be guilty of an offence.
Please note that the following categories of students do not qualify to apply for the
loan: (i) upgrading students studying at any university) postgraduate students
1. PERSONAL DETAILS
Full name:
First or given names
Male:
Father’s name
Surname or family name
Female:
Date of birth:
Student ID No (attach copy):
Contact cell number:
Email:
Home address:
Current address:
B. Education Background
Level
Primary
Institution Name
Attach certificate copies of your highest certificate
Certificate Obtained
Secondary
A-Level
…
Year (From)
Year (To)
C. Details of Parents/Guardian
Father/Mother/Guardian
FULL NAME:
Highest Education Level (tick):
RELATION:
(simply Tick)
None
Contact address
Is she/he Employed?
Primary
Father
Mother
Secondary
Tertiary
Guardian
University
Telephone Number:
Occupation/Profession:
If employed, contact number of the
employer
D. Declaration**
Applicant
Parent/Guardian
I declare that the information is true
to the best of my knowledge. I also
understand that this is loan that must
be repaid
I declare that the information is true to
the best of my knowledge. I also
understand that this is loan that must be
repaid
Name:……………………………..
Signature…………………………..
Date:……………………………….
Name:……………………………..
Signature…………………………..
Date:……………………………….