Skip to content
Home
About Us
Capital as a Service
Apply Now
Contact Us
Menu
Home
About Us
Capital as a Service
Apply Now
Contact Us
Apply Now
Please note that only an authorized company representative may submit a company’s loan application
Blueprint Capital Loan Application Form
Section 1 - Business Information
Business Name
Type of Entity
- Select -
Pty (Ltd)
CC
Sole Proprietary
Partnership
Other
Business Location
Since
If less than 5 years state previous Plot No.
Business Operations started
Section 2 - Director's Personal Details
Title
- Select -
Mr.
Mrs.
Miss
Dr.
First Name
Last Name
Marital Status
- Select -
Single
Widowed
Divorced
Married O.C.O.P
Married C.O.P
Maiden Name (Married Women)
Date of Birth (DD/MM/YYYY)
Omang / Passport No.
Nationality
Section 3 - Director's Contact Details
Cell/Mobile No.
Telephone - Work
Telephone - Home
Email
Postal Address
House Plot No.
For how long have you been living at the house?
If less than 5 years state previous House/Plot No.
Home Village
Ward
Headman
Section 4 - Business Bank Details
Bank Name
Branch
Account Type
- Select -
Current
Savings
Other
Account Number
Since
Section 5 - Director's Employment Details
Name of Employer
Location
For how long have you been with this employer?
Are you employed on a contract basis?
Yes
No
If yes, please state expiry date
Applicant Designation
Section 6 - Next of Kin (If married, details of spouse)
First Name
Last Name
Relationship
Place of Employment
Cell/Mobile No.
Telephone - Work
Telephone - Home
House / Plot No.
Town / Village
Home Village
Ward
Headman
Date of Birth
Date of Marriage
Omang / Passport No.
Section 7 - Help Us Understand a Little More About your Business
How much turnover (revenue) did your business generate over the past 12 months?
- Select -
Less than P250k
P250k - P500k
P500k - P1mil
P1mil - P2.5mil
P2.5mil - P5mil
P5mil - P10mil
P10mil - P20mil
More than P20mil
Does your business supply goods and services to any large corporate or public sector entity?
- Select -
Yes
No
How many people do you employ?
- Select -
1 - 10
10 - 50
50 - 100
100 - 1000
1000 - 5000
More than 5000
Section 8 - Help Us Understand a Little More About your Funding Requirements
What amount of funding facility do you require (in BWP)?
Fixed Interest Rate (%)
Fixed Admin Fee (%)
Total Loan Amount
Interest Amount (7.5%)
Admin Fee Amount (1.5%)
What type of working capital facility do you require?
Purchase Order Financing
Invoice Discounting
Line of Credit
Revenue Financing
Section 9 - Document Upload
Documents to Upload (Use the "Choose File" button below to upload documents then tick all the documents uploaded using this checklist)
Company Profile
Incorporation Documents
Company Resolution
Certified Identification Documents of Directors
Valid Purchase Order / Contract
Quotation for Goods & Services to be Supplied
Letter of Cessation
Proof of Place of Operation
Current Trading License
Valid Tax Clearance Certificate
6 Months Bank Statements
Click below to upload a file (Repeat step until all relevant documents are uploaded)
Choose File (PDFs only)
Section 10 - Confirmations
I confirm that the information I have provided in each of the sections is correct.
I confirm that the information I have provided in each of the sections is correct.
I consent to the processing of my data / information for the purposes of the application.
I consent to the processing of my data / information for the purposes of the application.
Submit
Ready to Grow with Us?
Get in Touch Today
Apply Now
More About Us