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CUSTOMER APPLICATION FORM
Personal Information
First name
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Last name
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Email
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Phone Number
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Monthly Income Range
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10,000.00 to 200,000.00
200,001.00 to 500,000.00
500,001.00 to 1,000,000.00
1,000,001.00 to 5,000,000.00
5,000,001.00 and above
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Property Information
Preferred Location
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Property Type
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Duplex
Bungalow
Semi Detached
Flat
Terrace
Others
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Possible Cost of Property
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Projected time of Acquisition
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Number of Bedrooms
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1
2
3
4
5
6
7
8
9
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Will You be needing a Mortgage?
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Mortgage Type
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NHF
FHF
Homebase Mortgage Loan
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Employment Information
Employment Type
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Employed
Self Employed
Others
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Bio-Data
Gender
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Male
Female
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Date of Birth
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Marital Status
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Single
Married
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