NCR Registration Number NCRCP10082 MyWealth Investments Loan Application Step 1 of 9 11% Consent to credit references, solvency declaration and spousal consentConsent* I agreeI hereby consent to MyWealth Investments to process my personal information for the purpose of this applicationFull names Identity_numberI consent to MyWealth Investments enquiring my credit record with any credit reference agency as well as any updates about the conduct of my accounts, including the failure to meet the agreed terms and conditions. I also agree that the credit reference agencies may, in turn, make my records and details available to other credit grantors. I further consent to you carrying out identity and fraud prevention checks and sharing information about this application through the South African Fraud Prevention Service.Capture WebcamUpload proof of IdentificationMax. file size: 512 MB.Note: South African green bar coded ID or Smart Card IDI am currently insolvent* Yes No Date of application MM slash DD slash YYYY Student loan applicationName First Last Full names Student loan details New student loan Current student loan Student NumberWho may applyTo be eligible for application: 1.You need to be 18 years of age 2.Principal debtor must earn a minimum of 4000 per month 3.You need to be studying towards a certificate, an undergraduate or postgraduate degree or diploma at Regenesys. If you are going Into your first year, you need to have a Matric Certificate. You need to have passed your previous year of study if you are going into your second or subsequent years. Monthly instalments must be paid by debit order. HiddenDo I need insurance cover for my loan ? Its recommended that a personal loan protection plan be taken to repay any outstanding debt on the loan n the case of death dread disease or disability.I would like a credit life insurance cover Yes No I give consent to take up credit life insurance cover for myself I agree to credit life insurance coverProof of Registration at Regenesys Business SchoolMax. file size: 512 MB.Latest Academic ResultsMax. file size: 512 MB.Matric CertificateMax. file size: 512 MB.Grade 12 Certificate (Matric Certificate)Other QualificationsMax. file size: 512 MB. PART A Student’s detailsName First Name Surname Full names As per IDID NumberDate of birth MM slash DD slash YYYY Mobile numberWork or office phone numberDate of application MM slash DD slash YYYY Email Postal Address Street Address Address Line 2 City Province Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Physical Address Street Address Line 1 Street Address Line 2 City Province Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Proof Of ResidenceMax. file size: 512 MB.Note: Please provide your recent utility bill(municipal water and lights account), bank statement or tax certificate. Marital Status of SponsorStatus Single Divorced Married in community of property (need spousal consent) Married out of community of property Other (please specify) Specify marital status I confirm that the spousal consent is held by me*If I am married in community of property I need my spouse’s consent in terms of the Matrimonial Property Act No. 88 of 1984 before entering into this agreement. Yes Spouse name First Last Spouse proof of identificationMax. file size: 512 MB.Signature of spouse*Number of dependantsConfirmation I confirm that all this information is true Banking account details of SponsorAccount Name Bank Name Branch Name Account Number Do you have any other bank accounts including other loan accounts? Yes No If yes, provlde detailsOther LoansBank Name Branch Name Account Name Loan Limit Monthly Repayment Outstanding Balance Latest three months bank statements Drop files here or Select files Max. file size: 512 MB. Employment detailsAre you a full time,part time or self-employed? Full-time Part-time Are you self-employed If yes, for how long? Nature of Business If yes, for how long? Occupation Period with present employer (YY-MM) Monthly Income Name of present employer Copy of Salary Advice ( Payslip)Max. file size: 512 MB. Details of Planned StudiesWhich mode of have you registered for ?Full timeOnline learningWhich academic qualification have you registered for ?Certificate in Business ManagementCertificate in Project ManagementCertificate in Human Resource ManagementMaster of Business AdminstrationHigher Certificate in Public ManagementCertificate Programme in Municipal FinanceBachelor of Accounting SciencePostgraduate Diploma in Public ManagementMaster of Public ManagementAcademic Qualifications Description- E-learning(Distance)Higher Certificate in Business ManagementHigher Certificate in Business Management-Retail ManagementHigher Certificate in Business Management- BankingBachelor of Business AdministrationBachelor of Business Administration (with online tutorial support)Bachelor of Business Administration -Retail ManagementBachelor of Business Administration-BankingPostgraduate Diploma in Business ManagementPostgraduate Diploma in Business Management(with online support)Master of Business AdministrationYear of Study Expected Completion Date Final Year Yes No Have you changed courses ? Yes No State year of changes PART B Loan requirement for forthcoming year of studyAmount applied for R Balance on existing loan (if applicable) R Total amount of student loan R Additional InformationPlease give details of any relevant information that might affect our decision on this student loan application Consent I declare that to the best of my knowledge and belief, the particulars set out in this application are true and correct, and that no additional information which might affect the decision of has been withheld.Consent* I agree to the privacy policy.I accept the terms and conditions for student loans Δ
