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WE ARE
BUSINESS/PARTNERS
WE ARE
BUSINESS/
PARTNERS
Complete this form and we will contact you shortly.
Name (Required Field)
*
First
Last
Cell Number
Email Address
*
Name of Business
Years in Business (Required Field)
*
How many years have you been in business?
New Business
1 - 2 Years
2 - 5 Years
Over 5 Years
Over 10 Years
Do you own any other businesses? (Required Field)
*
Do you own any other businesses?
Yes
No
Do you have a question for us?
Loan Amount (We do not provide finance below US$50,000)
What is your desired loan amount?
US$ 50 000 - US$ 250 000
US$ 250 000 - US$ 500 000
US$ 500 000 - US$ 1 million
*Please choose amount in US Dollars ($). Loan amounts in local currency should be converted to USD ($).
Reason for loan
Region (Required Field)
*
Choose a branch closest to you
Kenya - Nairobi
Kenya - Mombasa
Kenya - Nakuru
Kenya - Kisumu
Kenya - Other
Malawi
Namibia
Rwanda - Kigali
Rwanda - Other
Uganda - Kampala
Uganda - Entebbe
Uganda - Jinja
Uganda - Other
Zambia
How did you hear about us? (Required Field)
*
Please let us know how you found us
Internet/Google Search
Facebook
LinkedIn
Youtube
An advert on another website
Radio
Television
Newspaper/Magazine
Referred by someone
Name
This field is for validation purposes and should be left unchanged.
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