Skip to content
Home
About Us
Capital as a Service
Apply Now
Contact Us
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
Select Country
Afghanistan
Aland Islands
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belau
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Saint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
British Virgin Islands
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo (Kinshasa)
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Ivory Coast
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao S.A.R., China
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Korea
Northern Mariana Islands
Norway
Oman
Pakistan
Palestinian Territory
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo (Brazzaville)
Reunion
Romania
Russia
Rwanda
Saint Barthélemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin (Dutch part)
Saint Martin (French part)
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia/Sandwich Islands
South Korea
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Swaziland
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom (UK)
United States (US)
United States (US) Minor Outlying Islands
United States (US) Virgin Islands
Uruguay
Uzbekistan
Vanuatu
Vatican
Venezuela
Vietnam
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
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
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
