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Choose your employment status
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Tech
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Human Resources
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Salary frequency
Weekly
Fortnightly
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None
Loan amount
Loan term
1 month
2 months
3 months
Title
Mr
Ms
Mrs
Dr
Prof
First Name*
Last Name*
Date of Birth*
ID number*
Marital Status*
Single
Married
Widow
Divorced
Gender*
Male
Female
Ethnicity*
Black
Coloured
Indian/Asian
White
Home language*
Afrikaans
English
IsiNdebele
IsiXhosa,
IsiZulu
Sepedi
Sesotho
Setswana
SiSwati
Tshivenda
Xitsonga
Mobile Number*
Email
Employee/Persal number
Work telephone number
Present Address*
Province*
City*
Postal / Zip Code*
I hereby agree that the information given is true, accurate and complete as of the date of this application submission. **
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Company Reg No: 2024/573762/07
National Credit Regulator Reg No: NCRCP21016
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