Attach

3 passport

photographs

Serial No. .......................

This Loan Application Form attracts a Increasing Access to Higher Education

Processing fee of K2,000

HIGHER EDUCATION STUDENTS’ LOANS AND GRANTS BOARD

STUDENTS’ LOAN APPLICATION FORM

TO BE COMPLETED BY ALL STUDENTS APPLYING FOR STUDENT’S

LOAN
(Complete all sections in Capital /Block Letters)

CAUTION: Any person or student who when filling a Loan Application Form, or during cross examination
knowingly makes a false statement whether in writing or orally relating to any matter affecting the request
for a Loan shall be guilty of an offence punishable by law

A. PERSONAL DETAILS OF THE APPLICANT

Surname: First Name: Other Names: Gender: F M

Identification (Please tick & provide as many as you can) -School ID -Passport -Driving
Licence - Voter’s Card National Identification (ID)
Post Office Box No: Telephone(s)
Email Address District of Origin
Township /Constituency of origin
Village Ward
Do you have any disability? Yes
No
(if yes, please specify and attach
certificate)
Special Learning Need if any(please Date of Birth_____DD _____MM
specify) _____YY______
(attach birth certificate where possible)
Marital Status(tick) Single Married Divorced Widowed
Attach applicable documents

B.DETAILS OF INSTITUTION TO WHICH YOU ARE ADMITTED (attach copy

of admission letter)
Institution Name
Faculty
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Year of Admission
Registration Number
Academic Year Loan Applied for 1st Year 2nd Yr 3rd Yr
4th Yr 5th Yr
Program Admitted for
Program Duration

C. (i) APPLICANT’S EDUCATION BACKGROUND

INFORMATION
Level of Institution/Schools Year of Fees Paid Fees Paid by
Education Attended Completio Per Year
n
Universities
Attended
(1)
(2)
Tertiary
(1)
A’ Level
Schools
Attended
(1)
(2)
Secondary
Schools/”O”
Levels
Attended
(1)
(2)
(3)
Primary
Schools
Attended
(1)
(2)
(3)
(II) CURRENT SPONSOR
Who is paying your fees

(iii) PREVIOUS SPONSOR

Who paid your fees during
a) A Level …………………………………………………………………………………….
…………………………………………
b) Secondary
…………………………………………………………………………………………………
……………………….
c) Primary
…………………………………………………………………………………………………
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 ……………………………
If guardian/well wishers, what relationship do you have with this person ………….
…………………………
If organisation, please provide name and contact details:
……………………………………………………………..…
…………………………………………………………………………………………………………
………………………………………………

Provide historical background of how your education has been

funded…………………………………………………………………………………………………
…………………………………………………………………………………………………………
…………………………………………………………………………………………………………
…………………………………………………………………………………………………………
…………………………………………………………………………………………………………
………………………………………………………………………………..

D. APPLICANT’S RESIDENTIAL CONTACT DETAILS (CURRENT ADDRESS)

District Emergency Contact Person
T/A Contact Telephone
Ward Name of Next of Kin
Village/Township/Constituency Relationship with Next of Kin
Street Occupation of Next of Kin
Plot No.(Where applicable) Location of Next of Kin

E. LOAN AMOUNT REQUIRED FOR THE ACADEMIC YEAR

a) Tuition for one academic year MWK
b) Stationery required for one MWK
academic year
c) Upkeep required for one academic MWK
year
TOTAL LOAN AMOUNT (Addition of either MWK
a, b & c )
Total Loan Amount in words:

F. BANK DETAILS
Account Name
Name of Bank
Branch
Account Number

G. DETAILS OF PARENTS’ PERMANENT ADDRESS

(Where employed please attach parents latest payslip and if self-employed
attach proof of income e.g. financial statement/ bank statement and if deceased
provide death certificate)
i. FATHER
Surname First Name
Please note that ONLY fully completed loan application forms shall be processed 3 of 9
Other Names Profession
Date of Birth Highest Level of Education
P.O. Box Number Telephone(s)
Email Address Employer/ Nature of business
Current Residential Address Monthly Income: MWK
District Other Sources of Income: MWK
Deceased/Living
Town District of Origin
Ward Village of Origin
ii. MOTHER
Surname First Name
Maiden Name Profession
Date of Birth Highest Level of Education
P.O. Box Number Telephone(s)
Email Address Employer/ Nature of business
Current Residential Address Monthly Income: MWK
District Other Sources of Income: MWK
Deceased/Living
Town District of Origin
Ward Village of Origin

H. (i) DETAILS OF SIBLINGS

Where a sibling is on government sponsorship, please provide details and if
the space provided is not adequate, please attach additional information on a
separate sheet of paper.
Name Institution/School/Cur Level of Annual fees
rent-last Study/Class

(ii) DETAILS OF FAMILY DEPENDANTS

Name Institution/School/Cur Level of Annual fees
rent-last Study/Class

I. FAMILY SOCIAL ECONOMIC INDICATORS (Tick appropriately)

1. Total number of children from biological/adopting/foster

father.................................
2. Total number of children from biological/adopting/foster
mother...............................
3. Are your parents staying together? Yes..... No.....

Please note that ONLY fully completed loan application forms shall be processed 4 of 9
4. If no, with whom do you stay? a. Father............ b. Mother .......... c.
Others ...............
5. Type of Family residence.
a. Rented......... b. Owned......... c. Employer’s......... d. Other
(please Specify)............
6. Type of House a. Permanent ........................ b. Semi
Permanent............................
7. Number of rooms in the family
house........................................................................
8. Average Household monthly
expenditure..................................................................
Please provide estimated monthly expenses incurred by your family,
where applicable on the following:
i. Rent................................................................................
ii. Food...............................................................................
iii. Clothing..........................................................................
iv. Utilities...........................................................................
a. Water....................................................................
b. Electricity..............................................................
c. Gas........................................................................
d. Charcoal................................................................
e. Paraffin.................................................................
f. Firewood...............................................................
g. Airtime..................................................................
h. Pay TV...................................................................
i. Transport..............................................................
9. Where does your family seek medical care?
i. Private Missionary Hospital............................................
ii. Public Hospital ---------------------------------------
iii. Private Commercial Hospital/Clinic................................
iv. Insurance Cover (please specify)....................................
v. Others (specify)..............................................................

10. What means of transport does your family use?

a. Private means......................................
b. Public means.......................................
c. Employer’s Motor Vehicle..................
d. Bicycle.................................................
e. Other (please specify).........................

11. Please give reasons why you must borrow from HESLGB to
finance your University / Tertiary Education
............................................................................................................
............................................................................................................
............................................................................................................
............................................................................................................
............................................................................................................
........

Please note that ONLY fully completed loan application forms shall be processed 5 of 9
 12. Provide a historical background of how your education has
been funded
............................................................................................................
............................................................................................................
............................................................................................................
............................................................................................................
............................................................................................................
........

13. We encourage early loan repayments. Within your family, do

you have any family member who can support you by paying back
small instalments of your loan while you are still at university?
Yes.................... No..........................
If yes, please give us details on who will be responsible for remitting
these instalments
Names............................................................................................
Profession......................................................................................
Occupation/Source of Income.......................................................
Telephone Contacts.......................................................................
NB: If yes, this option will be formalised if and only if your
application is approved

J. TERMS AND CONDITIONS

1. The loan shall be repaid with a value maintaining fee (interest) of 25%
of the prevailing base lending rate in year of loan maturity.

2. The Board shall have the sole discretion of changing and varying the
interest rate as circumstances shall demand.

3. The Board retains the right to evaluate all loan applications and
determine the number of beneficiaries. (This application is not a
guarantee that the loan shall be approved)

4. In the event that the Loan Applicant discontinues studies for whatever
reason before full disbursement is made, the Board shall not disburse
the remaining allocation and shall recall the loan so far advanced in
full together with the interest thereon.

5. The loan shall be repaid in equal monthly instalment as per schedule

determined by the Board.

7. If a Loan Applicant defaults in repayment when the loan is due, the

whole amount shall become due and payable and the Loan Applicant
shall be bound to pay all other charges that may arise as a result of
the default including but not limited to legal fees and penalties.

8. The signature of the applicant shall certify the reading, understanding

and being in agreement with the terms and conditions herein.

9. There shall be a K2000 loan application processing fee and that the
application form shall be submitted together with a deposit slip of the
same. The amount should be deposited to Higher Education Loans
and Grants, Account Number 1001932884, National Bank of
Please note that ONLY fully completed loan application forms shall be processed 6 of 9
 Malawi, Capital City Branch.

10. No loan shall be disbursed unless the loan application form is

approved and upon the Loan Applicant completing the bonding form
which shall be required to be submitted to the Secretariat.

K. RECOMMENDATIONS (For newly admitted students Please

ensure that either of the Authorities below complete the form
accordingly)

OFFICIAL(please insert RECOMMENDATION/ OFFICIAL STAMP

Name & Signature) NOT RECOMMENDED
Local Councillor

Head Teacher of previous

School/ Institution
attended

L. Applicants check list (Cross Check whether all required information

is attached. Tick Appropriate)
i. 3 passport size..............
ii. Deposit slip of the Processing Fee……….
iii. Copy of applicant's lD...............
iv. Copy of institution's admission letter..........
v. Copy of fees structure.................
vi. Copy of Parent's/Guardian's ID..............
vii. Copy or copies of death certificate(s)(where available) if
orphaned.....................
viii. Copy of the MSCE/ “O” Level result slip....................
ix. Applicant to sign each and every page of this document...............
x. Copies of father's/Mother's pay slips (where applicable).................
xi. Copy of marriage certificate (where applicable)......................
xii. Sketch map to applicants home of origin.......................

M. DECLARATIONS BY APPLICANT

I am aware that the Board, at my cost, will protect its funds, i.e. the
Students' Loan against any such risk for such amounts which the Board
has approved and disbursed to me. In the event that any Student's Loan
is granted and accepted by me, I agree to be bound by the rules, terms
and conditions of the Board, and I undertake to sign all such documents
as may be required to secure a Loan from the Board. I acknowledge
liability for all costs that shall be incurred by the Board to recover its
funds from me. The costs may include Administration fees, documents
verification and Legal expenses that the Board may incur while pursuing
the loan
recovery. I further acknowledge that the commitments I have made in
this application shall continue to bind me from now onwards until the
entire loan is fully paid and I accept full responsibility and shall fully
indemnify the Board.

Please note that ONLY fully completed loan application forms shall be processed 7 of 9
 I undertake to notify the Board or its successors or assignees in title of
any change which materially changes any representation first above
mentioned.
I, the Applicant, hereby consent to you, the Board:
Receiving, compiling and retaining any confidential credit information
about me for purposes of (i) assisting you perform your statutory
assessment of my creditworthiness (ii) deciding whether to grant loan to
me and (iii) monitoring my credit profile, should you grant me loan;
I acknowledge that under Section 27 of the Higher Education Students
Loans and Grants Act, I am required to start repaying the loan within
two years upon successful completion of the course for which the loan is
granted or upon earlier termination of such course for any reason or
cause whatsoever.
I further hereby consent to the Credit Reference Bureau:
Please note that this information will be shared with the Credit
Reference Bureau or any office that might need it.
My signature hereto signifies my consent as aforesaid and my
agreement to hold you and any credit bureau and other credit provider
to whom you may provide my consumer credit information in terms of
my aforesaid consent harmless against any and all liability, loss, claim,
demand, cost, fees and expenses arising out of or from or in connection
with my aforesaid consent.
I hereby declare that the above information is true, and that I am aware
that making false statements on this form is an offence punishable by law.
I further declare that I clearly understand that this is a Loan which shall be
repaid.
Name: ....................................................................................................
Signature: ........................................................................
Date: ...............................................................................
Telephone Contact: .........................................................
Email.: .............................................................................

N. Parent/ Guardian/ Guarantor

I declare that I have read this form or this form has been read to me and I
hereby confirm that the information given herein is true to the best of my
knowledge.
Name: ..................................................
Telephone Contact ...............................
Mobile ...........................................................................................
Residential Physical Address: ...............
Employer (if applicable): ......................
Employer's Physical Address: ...............
Relationship with Applicant: .................
Signature: .............................................
Date: .....................................................

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O. DEAN OF STUDENTS

I confirm that the applicant is indeed a needy and deserving student for
the loans and I hereby state that the information given here is true to the
best of my knowledge.

Name: ..................................................
Telephone Contact ...............................
Mobile ..................................................................
Residential Physical Address: ...............
Employer (if applicable): ......................
Employer's Physical Address: ...............
Relationship with Applicant: .................
Signature: .............................................
Date: .....................................................

P. FOR OFFICIAL USE ONLY

APPRAISING LOANS OFFICER'S RECOMMENDATION LOAN

Amount MWK. Tuition...........................................................

Upkeep.........................................................
Stationery……………………...............................
TOTAL………………………………………………………
Loan Disbursement Phases (No.)......................................................
Proposed repayment mode..............................................................
I have verified the authenticity of the student's admission letters.

Comments.....................................................................................................
......................................................................................................................
......................................................................................................................
..........................................................................................
Loans Officer’s Name & Signature.......................................................
Date......................................

Q. DIRECTOR OF LOANS
Decision: - Approved/ Declined
Amount Approved MWK...........................................
Approved Loan Maturity Period...............................
Signature:...................................................................
Date...........................................................................

Please note that ONLY fully completed loan application forms shall be processed 9 of 9