Full Name * Email * Amount (NGN) * Transaction Charge: , Total: Phone Number * Gender Male female Age Range 18-35years above 35 Marital Status single married Divorced State of Origin State of Residency City LGA of Residency Residence Address Type of disability other disability Educational Qualification Primary/Secondary School OND/NCE or Equivalent 1st Degree/HND 2nd Degree Others Year of Graduation Computer Usage Yes No Language: can read & write English cannot read & write English Type of Employment: Unemployed Self-employed Employed Years of Experience Mobile Usage Call Call and SMS Call SMS and Internet Call SMS Internet and App Business Sector Business Activities Business Type Sole Proprietorship Joint Business Current No of Staffs 0-5 6-10 11-20 21-50 51-100 101-250 CAC Registered? yes No Bank Account Type Use Personal Acc for business Use separate Acc for Business Bank verification number * Banking Channel Physical Branch Use of separate Acc for Business Numbers of Years in Business Previous Loan Yes No Mode of training Offline Online * are compulsory ResetPay and Submit
