Student Loan Trust Fund Sltf Form

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					                         INSTRUCTIONS FOR FILLING LOAN APPLICATION FORM 
YOUR LOAN APPLICATION WILL BE PROCESSED BY PRECISION SOFTWARE. FAILURE TO FOLLOW INSTRUCTIONS WILL 
RESULT IN DELAYS IN PROCESSING YOUR APPLICATION. 

Complete ALL sections in CAPITAL LETTERS using a black ball‐point pen. Leave blank the space marked ‘OFFICE USE ONLY’. Do 
not let any letter/digit cross the box; one letter per box. In selecting Gender, Highest Academic Qualification, Marital Status, 
Public/Private school, mark X to denote your choice. 

CORRECTION OF ERRORS 
           • Do not use correction fluid anywhere on the form. The application will be rejected if it is used. 
           • Cancellations are not allowed. If you make mistakes, you are required to use a new form. 
 
SOCIAL SECURITY NUMBER & SOCIAL SECURITY REFERENCE NUMBER  
If you have not registered with SSNIT, go to any SSNIT branch office and register. You will be provided with a reference number.  
You can use this reference number to complete this application by filling it in the specified box. (Leave the Social Security 
Number box blank. However, you will have to notify SLTF when you obtain the actual number.  
If you have registered with SSNIT already and possess a SSNIT number, fill in the Social Security Number box and leave the 
Social Security Reference Number box blank. 
 
DISTRICTS & REGIONS 
In filling the Region & District boxes, refer to the APPENDIX attached and use the 4‐digit district code or the 2‐letter region 
abbreviation. 
 
E‐ZWICH ACCOUNT NUMBER    You require an e‐zwich account number to access the loan. Please register for the number at 
your bank if you do not have one already. Note that all your loan will be paid onto the card. 
 
PASSPORT PHOTO     You are required to submit 2 recent passport‐size photos. Write your name at the back of the photos and 
submit to the loan officer together with your application forms. DO NOT STAPLE OR GLUE THE PHOTOS TO THE FORMS. 
 
THUMB PRINT 
Take your thumb and finger prints at any SSNIT office close to you. 
 
LOAN GUARANTORS     Your application can be guaranteed by any of the following: 
      • SSNIT Pension contributor (who has contributed not less than 60months) 
      • SSNIT Informal sector fund contributor 
      • Metropolitan, Municipal, & District Assemblies 
      • Corporate Institutions 
      • Church / Islamic Denomination 
      Visit our website www.sltf‐ghana.org to download Guarantor Forms 
 
ATTACHMENT TO APPLICATION FORMS   
      • Copy of admission letter 
      • Copy of Student ID (if available) 
      • Copy of Social Security card or Reference Number receipt 
      • Copy of e‐zwich card 
      • One passport‐size photograph to each application form 
      • Guarantor Form & Loan Agreement Form 
 
NUMBER OF APPLICATIONS TO SUBMIT 
You are required to submit 2 copies of your application. Contact your loan officer for advice on this submission. 
 
Any questions, contact your campus officer, email to info@sltf‐ghana.org, or call 0302231886, 0302231887 
                              STUDENTS LOAN TRUST FUND
                  LOAN APPLICATION FORM                FIRST-TIME APPLICANTS

Form No




    SECTION I      - Applicant Details
     Surname                                                                          Date Of Birth (ddmmyy)



     First Name                                   Middle Name
                                                                                                Gender

                                                                                                    Male
     Social Security Number                            Social Security Reference Number
                                                  OR                                                Female


     Permanent Postal Address                              Home Address
     c/o (if applicable)                                   House No



     Box No                                                Street Name



     Town                                                  City/Town/Village


     Region         District Code(see Appendix)            Region     District Code(see Appendix)




     E- mail



     Telephone/Cellphone                          National ID Number(if available)



     Student ID Number




    SECTION II - Head Of Household/Person Responsible For Your Education

                                                                Marital Status
     Specify:
                  Father                                          Married

                  Mother                                          Divorced

                  Guardian                                        Never Married

                  Self                                            Separated

                                                                  Widowed
     Household Size (eg 03, 12)




  Page 1
                          STUDENTS LOAN TRUST FUND
                  LOAN APPLICATION FORM              FIRST-TIME APPLICANTS

Form No




  SECTION III - University/Polytechnic/Institution
 Name (Abbreviate if necessary)                                                                         Level
                                                                                                          L100

 Programme Of Study (As on Admission Letter)                                                              L200

                                                                                                          L300

 Enrolment Year (yyyy) Duration of Study (Years)                     Expected Completion Year(yyyy)       L400
                         1        2     3      4     5       6
                                                                                                          L500


  SECTION IV - Primary/Secondary School Details
  Senior High/Secondary
 Name Of School



 Location(City/Town/Village)                                              Region     District Code (See Appendix)


                                                         Ownership
 Enrolment Year(yyyy)    Completion Year (yyyy)
                                                            Public           Private
  Junior High
 Name Of School



 Location(City/Town/Village)                                                Region      District Code



 Enrolment Year(yyyy)    Completion Year(yyyy)           Ownership

                                                            Public           Private



                         Academic Qualification Reference Data

                               **     No Education

                               **     Primary School Only

                               **     Middle School / JSS

                               **     SSS / SHS

                               **     Secondary School O/A Level

                               **     Technical / Vocational

                               **     Tertiary Institution

                               **     Professional




     Page 2
                                STUDENTS LOAN TRUST FUND
                    LOAN APPLICATION FORM                FIRST-TIME APPLICANTS

Form No



                                                                        Select

  SECTION IV        Father/Guardian                                       Father         Guardian

 Surname                                                                 First Name



 Middle Name                                Telephone / Mobile Number


               Postal Address                                           Home Address
   c/o (if applicable)                                    House No



   Box No                                                 Street Name


   Town                                                   City/Town/Village


   Region      District Code                              Region        District Code



   Occupation / Profession



   Highest Academic Qualification (see Page 2)




                                                        Select

  SECTION V       Mother/Guardian                         Mother         Guardian

 Surname                                                                First Name



 Middle Name                                     Telephone / Mobile Number



                        Postal Address                                    Home Address
   c/o (if applicable)                                  House No


   Box No                                               Street Name


   Town                                                 City/Town/Village


   Region           District Code                       Region          District Code



   Occupation / Profession



   Highest Academic Qualification (see Page 2)




    Page 3
                                 STUDENTS LOAN TRUST FUND
                       LOAN APPLICATION FORM               FIRST-TIME APPLICANTS

Form No




    SECTION VII Guarantor Information

   Form Of Guarantorship
                                     Corporate/MMDA Guarantors/Churches/Islamic Denomination
      SSNIT Formal                   Name Of Organisation(abbreviate if necessary)
      SSNIT Informal
      Corporate
      MMDAs                            Postal Address
                                       Box No
      Church
      Islamic Denomination             Town


                                       Region    District Code



                                     Telephone Number                          Telephone/Mobile Number




     SSNIT Formal & Informal Guarantors
     Social Security Number                                      Relationship To Applicant
                                                                   Father         Mother        Any Other
     Surname                                                                   First Name



     Middle Name                                    Telephone/Cellphone



                                Postal Address                                   Home Address
          c/o (if applicable)                                    House No



          Box No                                                 Street Name



          Town                                                   City/Town/Village



          Region   District Code                                 Region        District Code




                                                                                     Office Use Only
  SECTION VIII E-zwich Account Data
                                                                      Program Code                 Loan Category
   e-Zwich No




    Page 4
                                                                  APPENDIX I: District Codes & Tertiary Institutions Codes 
WESTERN REGION                                                                  UPPER WEST                                                     0609 – Asante Akim South                                            TERTIARY INSTITUTION CODES
0101 – Ahanta West                                                              1001 – Jirapa                                                  0610 – Atwima Kwanwoma                                001‐Academy Of Business Administation (Accra Campus) 
0102 – Aowin/Suaman                                                             1002 – Lambussie Karni                                         0611 – Atwima Mponua                                  002‐Accra Polytechnic 
0103 – Bia                                                                      1003 – Lawra                                                   0612 – Atwima Nwabiagya                               003‐Africa Institute Of Journalism And Communications, Accra 
0104 – Bibiani/Anhwiaso/Bekwai                                                  1004 – Nadowli                                                 0613 – Bekwai Asante                                  004‐Akrofi‐Christaller Memorial Institute 
0105 – Ellembelle                                                               1005 – Sissala East                                            0614 – Bosome Freho new                               005‐All Nations University 
                                                                                                                                                                                                     006‐Ashesi University 
0106 – Jomoro                                                                   1006 – Sissala West                                            0615 ‐ Bosomtwe    
                                                                                                                                                                                                     007‐Bolgatanga Polytechnic 
0107 – Juaboso                                                                  1007 – Wa East                                                 0616 – Ejisu – Juaben Municipal 
                                                                                                                                                                                                     008‐Cape Coast Polytechnic 
0108 – Mpohor/Wassa East                                                        1008 – Wa Municipal                                            0617 – Ejura/Sekyedumase                              009‐Catholic University College 
0109 – Nzema East Municipal                                                     1009 – Wa West                                                 0618 – Kumasi Metropolitan                            010‐Central University College 
0110 – Prestea‐Huni Valley                                                                                                                     0619 – Kwabre East                                    011‐Christian Service University College 
0111 – Sefwi Akontombra                                                         VOLTA REGION                                                   0620 – Mampong Municipal                              012‐Data Link Institute (University College) 
0112 – Sefwi‐Wiawso                                                             0401 – Adaklu‐Anyigbe                                          0621 – Obuasi Municipal                               013‐Garden City University College 
0113 – Sekondi Takoradi Metropolitan                                            0402 – Akatsi                                                  0622 – Offinso Municipal                              014‐Ghana Baptist University College 
0114 – Shama                                                                    0403 – Biakoye District                                        0623 – Offinso North                                  015‐Ghana Christian University College 
0115 – Tarkwa Nsuaem Municipal                                                  0404 – Ho Municipal                                            0624 – Sekyere Afram Plains                           016‐Ghana Institute Of Journalism 
0116 – Wasa Amenfi East                                                         0405 – Hohoe Municipal                                         0625 – Sekyere Central                                017‐Ghana School Of Law 
0117 – Wasa Amenfi West                                                         0406 ‐  Jasikan                                                0626 – Sekyere East                                   018‐Ghana School Of Marketing 
                                                                                0407 – Kadjebi                                                 0627 – Sekyere South                                  019‐Graduate School Of Management (Kanda Campus) 
                                                                                                                                                                                                     020 Ho Polytechnic 
CENTRAL REGION                                                                  0408 – Keta Municipal                                           
                                                                                                                                                                                                     021 Institute Of Business Management And Journalism 
0201 – Abura/Asebu/Kwamankese                                                   0409 – Ketu                                                    BRONG AHAFO REGION 
                                                                                                                                                                                                     022 University College Of Management Studies ‐ Kumasi 
0202 – Agona East                                                               0410 – Ketu North                                              0701 – Asunafo North                                  023 Institute Of Professional Studies 
0203 – Agona West Municipal                                                     0411 – Kpando                                                  0702 – Asunafo South                                  024‐Intercom Programming And Manufacturing Company Ltd 
0204 – Ajumako/Enyan/Essiam                                                     0412 – Krachi East                                             0703 – Asutifi                                        (IPMC) 
0205 – Asikuma/Odoben/Brakwa                                                    0413 – Krachi West                                             0704 – Atebubu – Amantin                              025‐Islamic University College, Ghana 
0206 – Assin North Municipal                                                    0414 – Nkwanta                                                 0705 – Berekum Municipal                              026‐Jayee University College 
0207 – Assin South                                                              0415 – Nkwanta North                                           0706 – Dormaa East                                    027‐Koforidua Polytechnic 
0208 – Awutu‐Senya                                                              0416 – North Tongu                                             0707 – Dormaa Municipal                               028‐Kumasi Polytechnic 
0209 – Cape Coast Metropolitan                                                  0417 – South Dayi                                              0708 – Jaman North                                    029‐Kwame Nkrumah University Of Science And Technology 
0210 – Effutu Municipal                                                         0418 – South Tongu                                             0709 – Jaman South                                    030‐Maranatha Bible College 
0211 – Gomoa East                                                                                                                              0710 – Kintampo Municipal                             031‐Meridian University College 
0212 – Gomoa West                                                               EASTERN REGION                                                 0711 – Kintampo South                                 032‐Methodist University College ‐ Ghana 
                                                                                                                                                                                                     033‐Nar‐Bita School Of Nursing 
0213 – Komenda/Edina/Eguafo/Abirem                                              0501 – Akuapim North                                           0712 – Nkoranza North           
                                                                                                                                                                                                     035‐Pentecost University College 
0214 – Mfantseman Municipal                                                     0502 – Akuapim South                                           0713 – Nkoranza South            
                                                                                                                                                                                                     036‐Premier Institute Of Law Enforcement Management And 
0215 – Twifo/Heman/Lower Denkyira                                               0503 – Akyemansa                                               0714 – Pru                                            Administration 
0216 – Upper Denkyira East Municipal                                            0504 – Asuogyaman                                              0715 – Sene                                           037‐Presbyterian University College 
0217 – Upper Denkyira West                                                      0505 – Atiwa                                                   0716 – Sunyani Municipal                              038‐Rdi West Africa Limited 
                                                                                0506 – Birim Central                                           0717 – Sunyani West                                   039‐Regent University College Of Science And Technology 
GREATER ACCRA                                                                   0507 – Birim North                                             0718 ‐ Tain                                           040‐Spiritan Institute Of Philosophy 
0301 – Accra Metropolitan                                                       0508 – Birim South                                             0719 – Tano North                                     041‐Sunyani Polytechnic 
0302 – Adenta Municipal                                                         0509 – East Akim Municipal                                     0720 – Tano South                                     042‐Takoradi Polytechnic 
0303 – Ashaiman Municipal                                                       0510 – Fanteakwa                                               0721 – Techiman Municipal                             043‐Tamale Polytechnic 
0304 – Dangme East                                                              0511 – Kwaebibirem                                             0722 – Wenchi Municipal                               044‐Trinity Theological Seminary 
0305 – Dangme West                                                              0512 – Kwahu East                                                                                                    045‐University For Development Studies 
0306 – Ga East Municipal                                                        0513 – Kwahu North                                             NORTHERN REGION                                       046‐University Of Cape Coast 
                                                                                                                                                                                                     047‐University Of Education, Winneba 
0307 – Ga West                                                                  0514 – Kwahu South                                             0801 –Bole                                         
                                                                                                                                                                                                     048‐University Of Education, Winneba, (Mampong Campus) 
0308 – Ledzekuku‐Krowor Municipal                                               0515 – Kwahu West                                              0802 ‐ Bunkpurugu – Yunyoo          
                                                                                                                                                                                                     049‐University Of Education, Winneba (Kumasi Campus) 
0309 – Tema Metropolitan                                                        0516 – Lower Manya Krobo                                       0803 – Central Gonja                                  050‐University Of Ghana 
0310 – Weija Municipal                                                          0517 – New – Juaben Municipal                                  0804 – Chereponi                                      051‐University Of Ghana ‐ City Campus 
                                                                                0518 – Suhum/Kraboa/Coaltar                                    0805 – East Gonja                                     052‐University Of Mines And Tech (Umat) 
UPPER EAST                                                                      0519 – Upper Manya Krobo                                       0806 – East Mamprusi                                  053‐Valley View University College 
0901 – Bawku Municipal                                                          0520 – West Akim Municipal                                     0807 – Gushegu                                        054‐Wa Polytechnic 
0902 – Bawku West                                                               0521 – Yilo Krobo                                              0808 – Karaga                                         055‐West Africa Computer Science Institute 
0903 – Bolgatanga Municipal                                                                                                                    0809 – Kpandai                                        056‐Wisconsin Internation University College, Ghana 
0904 ‐ Bongo                                                                    ASHANTI REGION                                                 0810 – Nanumba North                                  057‐Zenith College 
0905 – Builsa                                                                   0601 – Adansi North                                            0811 – Nanumba South                                  058‐Ghana Institute Of Languages 
0906 – Garu–Tempane                                                             0602 – Adansi South                                            0812 – Saboba                                         059‐Green Hill College, Accra 
0907 – Kassena Nankana West                                                     0603 – Afigya – Kwabre                                         0813 – Savelugu/Nanton                                060‐Knust, Sunyani Campus (Formerly Crnr) 
                                                                                                                                                                                                     061‐National Film & Tv Institute 
0908 – Kassena/Nankana                                                          0604 – Ahafo Ano North                                         0814 – Sawla‐Tuna‐Kalba 
                                                                                                                                                                                                     063‐Regional Maritime University College 
0909 – Talensi‐Nabdam                                                           0605 – Ahafo Ano South                                         0815 – Tamale Metropolitan 
                                                                                                                                                                                                     064‐U.D.S. ‐ Navrongo Campus 
                                                                                0606 – Amansie Central                                         0816 – Tolon/Kumbungu                                 065‐U.D.S. ‐ Nyankpala Campus 
                                                                                0607 – Amansie West                                            0817 – West Gonja                                     066‐U.D.S. ‐ Wa Campus 
                                                                                0608 – Asante Akim North                                       0818 – West Mamrusi                                   067‐University Of Ghana Medical School 
                                                                                                                                               0819 – Yendi Municipal                                068‐Ghana Telecom University College (Gtuc) 
                                                                                                                                               0820 – Zabzugu/Tatale                                 069‐University College Of Management Studies ‐ Accra 
                                                                                                                                                                                                     070‐School Of Allied Health Sciences 
                                                                                                                                                                                                     071‐Technical University College 
                                                                                                                                                                                                     072‐Pan African Christian University College 
                                                                                                                                                                                                     073‐Ghana School Of Surveying And Mapping 
                                                                                                                                                                                                     075‐Western Hills School Of Nursing 
                                                                                                                                                                                                     076‐Evangelical Presbyterian University College 
                                                                                                                                                                                                     077‐Knutsford University College 
                                                                                                                                                                                                     078‐University Of Ghana ‐ School Of Pharmacy
ABBRE VIATIONS FOR REGIONS 
                                                                                                                                     
AR ‐  ASHANTI                             NR ‐ NORTHERN 
BA ‐  BRONG AHAFO                  UE ‐  UPPER EAST 
CR ‐  CENTRAL                              UW ‐  UPPER WEST 
ER ‐  EASTERN                              VR ‐  VOLTA 
GR – GREATER ACCRA                WR  ‐  WESTERN 
 
                                        STUDENTS LOAN AGREEMENT FORM



   This agreement is made this___              __day of _____________________20_ _between STUDENTS
   LOAN TRUST FUND, a Trust incorporated under the Trustee Incorporation Act, 1962, Act 106 of House No.
   47, 3rd Crescent Ave, Asylum Down, Accra, acting by its authorized representative (hereinafter referred to as the
   “LENDER”)               of          the            one              part
   and________________________________________________


   with student number ____________and whose Social Security number is
   (hereinafter referred to as the “BORROWER”) of the other part.
   WHEREAS:

1. The Lender has established a student‟s loan scheme to advance loans to students undertaking accredited courses
   at accredited tertiary educational institutions in Ghana in accordance with the requirement of the lender„s Trust
   Deed .
2. The Borrower is currently pursuing a             Year (Number of years) diploma/degree and or professional course
   at              _________________                      _ (Name of institution) an accredited tertiary institution.
3. At the request of the Borrower and subject to the terms and conditions of this agreement set out below and
   particularly explained in Appendix B attached hereto, the lender has agreed to advance loan to the borrower.
4. AMOUNT OF LOAN
   The Lender shall provide the Borrower with a Loan facility agreed by the parties herein and in the subsequent
   year(s) of the course of study of the Borrower. The Lender shall disburse the loan amount to the borrower of
   each year for the borrower‟s course of study by two installments. The amount of each installment shall be
   determined by the Lender and paid into a designated personal account of the borrower the particulars of which
   the borrower shall provide to the Lender.
5. TERMS AND CONDITIONS
   a) The Lender shall charge interest equal to the average Interest payable on Government of Ghana 182 day
       Treasury bill on total loan for the time being advanced to the borrower.
       (i) Compounded annually during the period of study and moratorium period ;
       (ii)Plus 2% compounded semi-annually during the payment period.

   (b) The Borrower shall repay the loan granted together with all interest accrued thereon within a     (number
        of years) of completion of the course or as the case may be and in accordance with the payment schedule
        attached hereto.
   (c) The Borrower shall provide at least one Guarantor acceptable to the Lender prior to the disbursement of the
         first Loan
   (d) The Borrower shall have the right at any time on written notice or otherwise to the Lender to repay all or
       part of the loan with the accrued interest.
   (e) Penalties for default shall apply in cases of default.
   (f) The Lender shall be entitled to terminate this agreement if borrower is found to have provided false
        information. In the event of termination of this agreement under this clause the principal and accrued
        interest shall become immediately payable.
   (g) The Borrower shall notify his employer in writing of his/her obligation to the Lender and request monthly
       deduction from salary and pay the money to the Lender.
   (h) If the Borrower fails to complete his course of study through any cause whatsoever the borrower shall
       remain indebted to the lender for the loan and the entire loan shall become due immediately and payable
       within 12 consecutive months.
   (i) A borrower shall not be eligible for a loan during repeat year(s) of study.
   (j) The borrower shall be automatically registered for the Students Loan Protection Scheme.


      _______________________________
      Signature of student
         Page 1 of 3
                                 STUDENTS LOAN AGREEMENT FORM

                             FINGER/THUMB PRINT OF APPLICANT




Left Index Finger   Left Thumb          Right Thumb        Right Index Finger        SSNIT Officer Signature

(Finger prints should be taken at any SSNIT branch office, supervised by an officer who should sign
his/her name, Stamp & Signature to the right)

                                       WITNESS (Refer to page 3)


                                       Name:                            Official rubber stamp
I wish to confirm that the applicant
appeared before me and that I          Address:
interviewed him/her and hereby
state that the information given
herein is true to the best of my
knowledge.
                                       Phone:


                                       Profession/Title:
Signature
_______________Date__________

               CONSENT OF PARENT/GUARDIAN (For Applicant under 18 years only)


I, ______________________________________________________________ (Name of Parent)


of___________________________________________________________________________________
                                 Residential Address


And with National ID number ______________________and NHIS number: ______________being a
Parent/Guardian of __________________________with student No. ______________________

consent to the grant of Loans by the Students Loan Trust Fund to my child/ward during his course of study
at _____________________________________________________________________________

Postal Address _______________________________________________________________________


Signature _____________________________________



Page 2 of 3
                               STUDENTS LOAN AGREEMENT FORM

ATTESTATION FOR VISUALLY IMPAIRED PERSONS ONLY

A. Borrower

   Signed by                                                                               after the
                                         (Name of borrower)

   Contents herein had been read and explained to him by                                   __ ____

 ___________________________________________________________________                       _______
                     (full name and address of the person explaining )

and seemed perfectly to understand and approve of same before his hand was guided by the said

                                           to the appropriate place on this application form to sign.
         (name of person explaining)



 (Signature of person making declaration)

B. Witness to attestation:
  Signature _____________________________________________________________________

 Full name: ___________________________________________________________________

 Occupation: ___________________________________________________________________

 Postal Address_________________________________________________________________


 I__________________________________________________________________________________

 _______________________________________________________________________________(full
 name ,address and occupation )hereby declare that on the_______day of__________(month ,year ). I
 read and explained the contents of the loan agreement marked to                                   (full
 name of borrower )the borrower herein who is blind but literate ,in the English language and he seemed
 perfectly to understand and approve of the contents before executing it.



LIST OF PERSONS QUALIFIED TO WITNESS (Refer to page 2)

      Senior Public Servant
      Religious Leader
      Village Chief
      Lawyer
      Senior Professional
      Head of Secondary Schools
      Dean of Student- Head of Department




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DOCUMENT INFO
Description: Student Loan Trust Fund Sltf Form document sample