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:……………………………….