Registration

Personal Details

Username^*

First Name^*

Last Name^*

Email^*

Password^*

Confirm Password^*

I.D Number^*

Contact Number^*

Employment Details

Employment status^*

Employer / Company name^*

Work Address^*

Contact Number^*

Affordability Details

Net salary: As per Payslip^*

Expenditure Medical Aid^*

Clothing^*

Insurance^*

Mortgage/Rent^*

Loan/Overdraft^*

Lights and water^*

Vehicle instalment^*

Other transport costs^*

Groceries^*

Pre-school/School/University^*

Next of kin Details

First Name^*

Last Name^*

Contact number^*

Relationship^*

Banking Details

Name of Bank^*

Account holder’s name^*

Account type^*

Branch code^*

Account number^*