ss Affix securely Passport size Photograph here. ZIMBABWE MINISTRY OF HIGHER AND TERTIARY EDUCATION, SCIENCE AND TECHNOLOGY DEVELOPMENT STUDENT LOAN APPLICATION SELECTION CRITERIA FORM Please read this Form before completing it When you have completed this application form, please submit it through your ‘State University/ Polytechnic/ Teachers College/ Industrial Training College Applicant wil be disqualified for providing any false information ‘CONDITIONS RELATING TO THE LOAN APPLICATION SELECTION CRITERIA 1 5. (1) Section A to be completed by the Student (ii) Section B to be completed by the Parent/Guardian/Loan Guarantor (lil) Section C to be completed by the Institution. The student must be a citizen of Zimbabwe. The surety must be a permanent resident or citizen of Zimbabwe. Loans are meant to assist, first and foremost, needy students. Payment of loans to the student shall cease if conduct, attendance or performance Is unsatisfactory. In such cases, loans advanced together with interest accrued shall be repayable forthwith. Repayment of loan shall be within one (1) year from the date money is borrowed otherwise next application will not be considered. SECTION A: Student Particulars (To be completed by the Student) 1 Names (Surname): Gender: Date of Birth Marital Status .. Residential Address Current Physical Address: Email Address:15. 16. Personal Mobile Number(s): Are you a citizen of Zimbat National I. D., Number: Relationship to Student .. Profession Residential/Physical Address .. Contact Mobile Number(s) .. Email Address (if applicable) .. Next of Kin 2 Relationship to Student .. Residential/Physical Address .. Contact Mobile Number(s) .. Email Address (if applicable) . If the next of kin lives in the Rural Areas, please supply the following Information: Name of Village .. Name of Village Head Name of Chief YEAR | SUBJECT GRADE OF PASS. EXAMINING BODY “O” LEVEL | SCHOOL | “A” LEVEL | SCHOOL17. 18, 19. Details of the Guarantor Name of Village .. Name of Village Head Name of Chief... Nearest Police Station Nearest School District Province If you were supported by BEAM or any other charitable organisation, please attach proof from the last school, signed and date stamped by the Ministry of Primary and Secondary Education administrative systems. PARTICULARS OF PROPOSED COURSE (attach offer letter and/or fees invoice and last result slip) Name of Institution .. Programme (Certificate, Diploma, Degree) .. Ity/Department Duration of Course in Years ‘Semester/Term you will be entering Date Course Commences ‘Year of Completion ... Please note that all approved loans shall be paid directly to the accounts of Institutions, balance to be paid to the student’s account STUDENT BANKING DETAILS Name of Account Name of Bank: Account Number: Branch: ...... DECLARATION BY STUDENT L .. am applying for a Loan of 2. to further my studies. I am unable to Pay for my fees on my own because of the following reasor (Provide or attach proof/evidence where necessary)I declare that the information I have provided Is, to the best of my knowledge and belief, correct. I further declare that any false Information that I supplied automatically nullifies this application. Signature of Student: Full Names of Witness 1; Signature of Witnes: Full Names of Witness 2: LD, Number: Date: .. Signature of Witness: Mabile No: ‘SECTION B: PARTICULARS OF PARENT/GUARDIAN (To be completed by parent/guardian/spouse) PARENT /GUARDIAN/SPOUSE (if married) 1, Full Names (Surname First) Relationship to student Residential Address Postal Address Current Physical Address If parent/guai Name of Village ... Name of Village Hea Name of Chief District Nearest Police Station . Nearest School .. National 1.D, Number; Occupation (a) Formal Employment Name and Address of Employer . Salary per month (b) Self-Employment State nature of self-employment and the location where you usually carry out this business (Attach latest pay slip)8. Bank details of surety: Account Name: OR Eco Cash/Tele Cash/One Money Number: ... a Moblle Number(s): 10, Are you a citizen of Zimbabwe? ... i Are you resident in Zimbabwe? If not, state country of residence State any movable/immovable property (e.g. house, Date: SECTION C: COMMENTS BY THE INSTITUTION LOAN SELECTION COMMITTEE 1, Is the information from the student the same with that provided by the parent/guardian/loan guarantor? 2 imended/Not Recommended (Justify) . Member of the Selection Committee Signature "Date Chairperson of the Selection Committee3. OFFICIAL DATE STAMPPartners For Success TERTIARY EDUCATION LOAN PRODUCT APPLICATION FORM Application date: ‘SECTION 1-STUDENT’S DETAILS (BORROWER) | surame 7 = FirstName (s) | a Mobile Number _ Physical Address: - - Email Address — - | Student Number DOB, Name of University / a ~ | Programme of - College Study L _ | Faculty Start Year Present Semester End Year | Surname IDNo. — First Name (3) Physical Address | Postal Address | - | Property Ownership ned a] Rented [reneeeeefeg [Eee - (Tek) bo { parents/relatives Employer and J Employee Physical Address Number Years With Current |Tel. Work — Employer - | occupation __| Email Address _|Type of Employment (Tick) Permanent| Contract Temporary Self Employed Gender Female Male ‘Marital Status (v sf Tick) as | ‘Number of Dependants Details of other Name of Lender/Bank Limi] Repayment Current/outstanding | borrowings balance Relationship to Student Loan amount being shure ( maximum 12| i | pte tor ths) Three te Banta on Repayment iret SlryDeaucion” [) Debit My Account With: lethod (Vv Tick) jank Transfer/Deposit the oan Repayment top Order, mount ee SECTION SINCOME DETAILS — Income Frequenoy [_onthiy | annuaty [Other Speci _ Net nome per Month Monthly Expenses = OO — —_ ~ Disposable income SECTION 4-UNIVERSITY / COLLEGE BANK ACCOUNT DETAILS | Name of Bank a Bank Account Name 7 Branch | Branch Code | Account Number - - - oO - Loan Purpose (v Tick) Tulon Fees] Accommodation Outstanding Fee] "SECTION 5-REFERENCES 7 |Full Name i Residential - Address Home Telephone Email - —_ Business Mobile Address ‘Numbers Telephoneul "have attached copies of 7 !D document for: Parent/guardian/guarantor = Student Passport sited photo: Parent/guardlan/euarantor]_ 1] Student | Later Salary aévee slp [LE] oerorcototincome University/college recommendation letter Latest Water/ZESA Bill Ea DECLARATION Veccet ‘Admission/enrollment Lette — ‘wsnnsnennnnenas the Borrower, am acknowledging {hat | have read, understood and agree to al the terms and conditions contalned here. undertone Mon Senne ths Application Form signifies my acceptance tobe legally oun by these terms and condos. hereby siren hat the above statements are iru and complate and authorize CBZ Bank Limited to make any engulig EER May be considered necessary for confirmation of these facts and credit assessment. agree to be bound by the terms and conditions of the Tertiary Education Loan Scheme which | confirm to have vead eo fully understood jaragie domicile candi et executand tthe residential address shown above and hereby submit myself tothe ‘rlssitlon ofthe courts of Zimbabwe In any dispute arising rom this agreement, notwitheteeding thee the vane that proceedings are commenced | am domicied outside Zimbabure On this DAY OF ear Borrower (student) ae NAME: (Month)... (Year) SIGNATURE: (Ce-borrower! Farent/duard'an/Guarantor eg NAME: ces SIGNATURE: Teimis and Condmong 14 The Tertiary Educational Support Facity loan is intended to provide financing to Zimbabwean students ‘who have quaifled for tertiary education n Zimbabwe and are abe or have parents/guarcians/guarantors ‘who are wiling and able to make repayments over the specified tenure 12 Students should apply forthe loan after being admitted atthe university / college but before the opening Gate to allow ample time for processing and remittance, Letter of confirmation of enrolmest anu ‘recommendation from the University / College should be attached. 12° The primery borrowers (Parents or Guardians) shouldbe aduits, with cspacty to contract and are able to execute all facility documents in respect of the facil 14 The purpose ofthe loan will be to pay university / college fees and/or tution, Al payments are done rectly to the University / College 15 University / College fees invoice and letter of confirmation from the Univesity / College should be Submitted. However, the Loan amount wl aso be informed by atfordabilty as supported by the soure of repayment 16 Fach application should be accompanied by contact deta ofa retere as selected by the applcants. The 2oplicants should be willing to have cal backs performed on the referee toconfiem that they sell knoon to each other. 1.7 Loan repayments or instaiments should not exceed 40% of net income.1.8 The facility shall be charged 25% interest per annum alln {Including insurance}. (Subject to changes by the Bank) 1.9 Recommended applicants to deposit @ non-refundable loan administration fee (application and FCB search fees) as per prevailing Bank's pricing prior to loan disbursement 1.10 Prepayments are allowed, and a penalty rate in line with the institution's policy will apply forall overdue accounts, 2.12 The Bank will convey its decision within 10 working days from the date of receipt of the application ‘provided the application s complete, 2.12 The parent(s) or guardian ofthe student would be treated asa co-applicant ofthe student loan. Hisor her ‘ole would be, necessary, lke the primary debtor, 1.13 Students who have receives full Government or other scholarships are not eligible for the loan scheme 1.14 The loan shall not be available to students who discontinue the program midstream, fail or who are expelled from the University / College for disciplinary or other reasons. Discontinuation due to medical rounds will be accepted provided that necessary documentation to the satisfaction of the lending Institution Is submitted, 1.15 if the loan is in default then the foan is callable Immediately, « charge levied and all the methods of collection will be applied at the expense of the borrower and/or guarantors. 1.16 No variation ov amenciment ofthis Agreement shall be valid unless committed to in writing and signed by ‘oF on behalf of both parties. 1.27 By signing this Application Form, the borrower and co-borrower confirm acceptance of the terms and conditions, The Parties agree that the Credit Provider shall advance the Loan amount to the borrower and ‘co-borrower and pay the University / Collage whose detals are provided above. The borrower agrees that ‘the Credit Provider may change the date of deduction if the agread date has been changed by circumstances bayond the Parties’ control. Soar Sa RL Full NAME; .. Loan Purpose (v Tick) Accomodation [FT] Date application received: | Loan Amount Applied For {oan Tenure Repayment (exl. Interest) | First Loan Repayment Date | Last Repayment Date [terrors reser Loan Repayment Method | Direct Salary Deduction Credit History: ull Judgements: ‘Application recommended: Yes No Officer's Name: : Application approved: Yes Approving Manager's Name and Signature _