The information below will allow us to do a preliminary check to see if you qualify for a loan.
First Name *
Last Name *
Email Address *
Cellphone Number *
ID Number (Only RSA ID Numbers accepted) *
Loan Amount *
How did you hear about us?
Recommended by Doctor/Practice
Link to your Facebook Profile
You confirm that
You are not currently over-indebted
You are not under administration, sequestration or debt review and have not been declared mentally unfit by an order of court
All information you give us is true and correct
You confirm that you are able to read and fully understand English. If you cannot read English or do not fully understand English, you should not continue with this online application and should call us to apply in one of the other languages we support namely Afrikaans, Xhosa, Zulu or Sesotho.
U bevestig dat u Engels kan lees en Engels ten volle verstaan. Indien u nie Engels kan lees nie, óf Engels nie ten volle verstaan nie, moet u asseblief nie met hierdie aanlyn aansoek om ‘n persoonlike lening voortgaan nie. Skakel ons eerder: ons kan u telefonies in Afrikaans, Xhosa, Zulu of Sotho help om u aansoek te voltooi.
Uyaqinisekisa ukuthi uyakwazi ukufunda isiNgisi futhi usiqonda ngokuphelele. Uma ungakwazi ukufunda isiNgisi noma ungasiqondi ngokuphelele isiNgisi, akumele uqhubeke nokufaka isicelo nge-inthanethi kodwa esikhundleni salokho kumele usifonele ukuze ufake isicelo sakho ngolunye lwezilimi esizisebenzisayo, isiBhunu, isiXhosa, isiZulu kanye neSesotho.
netefatsa hore o kgona ho bala mme o utlwisisa Senyesemane ka botlalo. Haeba o sa kgone ho bala Senyesemane kapa o sa utlwisise Senyesemane ka botlalo, o tlameha ho se tswele pele ka kopo ena ya mokitlane wa motho ya inthaneteng mme o re letsetse ho etsa kopo ka e nngwe ya tse ding tsa dipuo tseo re di sebedisang, e leng Afrikanse, Sexhosa, Sezulu kapa Sesotho.
Uqinisekisa ukuba uyakwazi ukusithetha isiNgesi kwaye usiqonda ngokupheleleyo. Ukuba awukwazi ukusifunda isiNgesi okanye awusiqondi ngokupheleleyo, akufuneki uqhubeke - sifumaneka kwikhompyutha kwaye kufuneka ufake isicelo ngezinye iilwimi esizixhasayo ezizezi, isiBhulu, isiXhosa, isiZulu okanye isiSuthu.
I consent to be contacted for service feedback and/or information about other products and services.
I agree to receive correspondence via e-mail and not by post.
To obtain Credit Life Insurance (s44 of the Long-term Insurance Act).
Consent for the upfront initiation fee to be financed with principal debt.
By submitting this online application, you agree to the terms and conditions presented on this site.
MediFin Financial Services, a division of Commonwealth Finance South Africa (Pty) Ltd (Reg No 2012/154097/07), is an authorised Financial Services Provider (FSP46701) and Registered Credit Provider (NCRCP8071) MFSA number 7196.
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