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First Name :
Middle Name :
Last Name :
Date of Birth :
Aadhar Card No. :
PAN No. :
Gender : Male Female Other
Marital Status :
Email Address :
Address :
Street1 :
Street2 (optional) :
State :
District :
City :
Years living at Current Residence :
Residential Status :
Pincode :
Phone No. :
Mobile No. :
Alternate Contact No. :
Previous University : >
Previous College :
Previous Course/Class :
Category of Previous Course :
Marks obtained in Previous Course/Class :
Percentage CGPA(Grade) CGPA(Grade Points)
Select the Maximum Marks Obtained : outof
Eligibilty Test Taken(if any) : Yes No
Course Details for Which Loan is Required
Country of Study :
University of Study :
College of Study :
College Address :
Street1 :
Street2 (optional) :
State :
District :  
City :
Pincode :
Phone No. :
Contact Person Name  
Email  
Course Name :
Medium of Course : Full Time Part Time Correspondence Online
Type of course for which loan is required : Vocational Education Higher Education
Category of Course :
When loan is required? :
Due Date of Fees(if any) :
Total Fees :
Loan Amount (in Rupees) :
Self Contribution/Margin money :
Course Duration : in  
Is Applicant Working ? : Yes No
Type of Employment :
Name of Employer/Business :
Designation :
Years in Current Employment :
Gross Monthly Income :
Average Monthly Bank Balance for Last 3 months :
Address :
Street1 :
Street2 (optional) :
State :
District :
City :
Pincode :
Phone No. :
Assets and Investments : Yes No
Co-Borrower 1 Details
Relation with Student :
First Name :
Middle Name :
Last Name :
Date of Birth :
Aadhar Card No. :
PAN No. :
Email Address :
Same as Student's Address
Address :
Street1 :
Street2 (optional) :
State :
District :
City :
Years living at Current Residence :
Residential Status :
Pincode :
Phone No. :
Mobile No. :
Alternate Contact No. :
Type of Employment :
Name of Employer/Business :
Designation :
Years in Current Employment :
Employment Address :
Street1 :
Street2 (optional) :
State :
District :
City :
Pincode :
Phone No. :
Gross Monthly Income :
Assets and Investments : Yes No
Any Other Outstanding Loan : Yes No
Type of Outstanding Loan :
  Outstanding Amount EMI amount
Housing
Car
Jeep
Two-wheeler
Consumer Durables
Amount of Outstanding Loan :
Total EMI Amount :
Average Monthly Bank Balance for Last 3 months :
Select to add Co-Borrower 2 Details

Can Offer Collateral Security? : Yes No
Best Day to Call You Regarding Loan :
Any Day Monday
Tuesday Wednesday
Thursday Friday
Saturday Sunday
Best Time to Call You Regarding Loan :
Any Time
Morning
Afternoon
Evening
Additional Information
Additional Information/Query(if any) :
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