Women’s Micro Bank
Loan Product Type *
IMSME / MSME / SME Business LoanGovernment / SOE Salary LoanBack to School / Personal LoanRefinance Loan
Loan Amount Requested (PGK) *
Proposed Repayment Term *-- Select Term --3 Months6 Months12 Months24 Months36 Months
Primary Purpose of Loan *-- Select Purpose --Working Capital / Business StartupSchool Fees / EducationDebt RefinancingOther Personal Expense
Full Name *
Date of Birth *
Gender *
FemaleMale (Family Member)
Mama Bank Account Number (If known)
Primary Phone Number *
WhatsApp Number
Email Address
Residential Address / Village *
District / Province *
Primary ID Type *-- Select ID --National Identity (NID) CardDriver's LicensePassportWork ID Card
ID Card Number *
Expiry Date
Are you biometrically registered with Mama Bank?
YesNo
Fill out the section that corresponds to your economic profile.
Option A: For Business & MSME Applicants
Registered Business/Trading Name
Type of Economic Activity-- Select Category --Agriculture / LivestockRetail / Canteen / Market VendorMarine / FisheriesServices / TransportOther Business Activity
Years in Continuous Operation
Estimated Monthly Revenue (PGK)
Affiliated Association / Church Group / Cooperative (If any)
Option B: For Salary & Wage Earners
Employer Name
Payroll Type-- Select Payroll --Government Sector (ALESCO)State Owned Enterprise (SOE)Private Corporate Sector
Net Fortnightly Take-Home Pay (PGK)
Length of Employment (Months/Years)
Proposed Security Option (Select matching option where applicable)
Cash Security / Equity Savings Balance held at Mama BankThird-Party Co-Signer / Peer Group Mutual GuaranteeSalary Deduction / Payment Variation Authority (PVA)Unsecured / Under Government SME Credit Scheme
1. Copy of Valid Identity Card *
2. Income Evidence (Last 2 Payslips OR 3 Months Business Record Book Pages)
3. Supporting Documents (PVA Confirmation Letter, School Fee Invoice, or Refinance Payout Letter)
By clicking the authorization check box below, I formally declare that all options, parameters, and details entered into this layout form are true and accurate. I actively authorize Women's Micro Bank Limited to run necessary background verification checks against my bank records, current employers, third-party loan records, or financial regulators. I understand that processing requires a validation of my biometric record at a physical banking point.
Yes
