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BOOST AFRICA FUNDING PARTNER APPLICATION FORM
Boost Africa (Pty) Ltd
Reg No: 2024/617245/07
NCRCP20750
SECTION 1 – PERSONAL INFORMATION
Full Name / Company Name
ID Number
Date of Birth
Nationality
*Phone Number
*Email
Residential Address
City / Province
Postal Code
SECTION 2 – EMPLOYMENT / BUSINESS INFORMATION
Employment Status
.
Employed
.
Self-Employed
.
Business Owner
.
Retired
SECTION 3 – FUNDING DETAILS
Funding Amount
Text Field
Have you previously participated in funding programs?
.
Yes
.
No
SOURCE OF FUNDS
.
Salary / Employment Income
.
Business Income
.
Savings
.
Investment Returns
SECTION 4 – DECLARATION
I confirm that the information provided in this application is true and accurate. I understand that: • Approval is subject to review by Boost Africa. • Participation is governed by the Funding Partner Agreement. • Returns are performance-based and depend on loan portfolio performance.
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