Retail Credit

Education Loan Application Form

* denotes mandatory

A: Student’s Details
Full Name *
Permanent Residential Address
PAN No. (if any)
Email *
Phone No. *	Residence				Mobile
Present Residential Address *
UBI’s nearest Branch to Residence
Period of Stay in Current Residence
B: Parent/Guardian’s Details
Name *
Relationship with students *
Occupation
	PAN No. *
	Annual * Income
Residential Address *
Phone No. *	Residence
	Office
	Mobile
Value of Immovable * Properties owned
Others Assets
Value of movables owned *
Tot. Otg. Liabilities *
C: Previous Examination Details * (Please enter atleast one details)
Examination 1 Name of the Examination School/ College/ Board/ University % of Marks Secured
Examination 2 Name of the Examination School/ College/ Board/ University % of Marks Secured
Examination 3 Name of the Examination School/ College/ Board/ University % of Marks Secured
Examination 4 Name of the Examination School/ College/ Board/ University % of Marks Secured
D: Details of Course for which loan is applied
Course Name *
Nature of Course *
Selection Procedure *
Scholarship, if any
Duration of Course *
% of Marks/ Grade/ Rank obtained in Selection Procedure *
Name And address of the * College/ University/ Institution
E: Quantum of Loan
Total Expenses on Study *			Loan * Requested
F: Securities Offered
Land & Building Nature Location Value
Financial Securities Nature Value Maturity
Third Party Guarantee Name of Guarantor Relationship with the student Net worth
Others (Please give details)
Enter Image Verification Code *