37A, Adebayo Doherty Road, Off Admiralty Way, Lekki Phase 1, Lagos

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Loan Application Form

By filling and submitting this form, you have expressed your interest to secure a loan facility from Shalom Microfinance Bank.
Our Credit Management Team will be in touch with you after reviewing your application and supporting documents.

Kindly Note:
Before you start filling the Loan Request Form, please make sure you have the following documents on hand as you will be required to upload them as attachments to the form:

  1. Completed Guarantor Information Document (Click Here to Download)
  2. Completed Guarantor’s Agreement Form (Click Here to Download)
  3. Form of Identification (e.g. Driver’s License, National ID, Intl. Passport)

Full Name (required)

Phone (required)

Email (required)

Gender

Age (required)
18 - 2526 - 3536 - 4546 - 5960 - Above

Address (required)

Occupation (required)

Employment Status

How long in business (required)

How long have you been employed (required)

Average Montly Income(required)

Means of Idenification

Place of Issuance (required)

Issue Date (required)

Expiry Date (required)

Upload Driver's License (required)

Place of Issuance (required)

Issue Date (required)

Expiry Date (required)

Upload National ID (required)

Place of Issuance (required)

Issue Date (required)

Expiry Date (required)

Upload International Passport (required)

Kindly Specify (required)

Place of Issuance (required)

Issue Date (required)

Expiry Date (required)

Upload ID Card (required)

Marital Status

Name of Spouse (required)

Is your spouse employed?

Occupation (required)

Name of Company (required)

Address (required)

Next of Kin (required)

Relationship (required)

Address (required)

Loan Amount Requested (₦) (required)

Loan Type (required)
BulletSalary AdvanceConsumer FinanceLPO FinancingLifestyle Loans

Duration (required)

Upload Guarantor Information Document (required)

Upload Guarantor's Agreement Form (required)