HIGHER EDUCATION STUDENTS' LOANS BOARD

(BODI YA MIKOPO YA WANAFUNZI WA ELIMU YA JUU)

HESLB House, 1 Kilimo Street, TAZARA Area, Mandera Road.

P. O. Box 76068, Dar es Salaam, Tanzania
Tel: (General) +255 22 2669036/2669037; Fax: +255 22 2669039;
E-mail: info@heslb.go.tz; Website: www.heslb.go.tz

STUDENTS LOAN APPEAL FORM (SLAF1) Form # :95094A69093-COPY

1 : Personal Particulars

Surname: KIMAMBO
Other names : DINA BELTON
Form Four Index # : S0269.0016.2018

2 : University Admission Details

Academic Year : 2021/2022 Year of Study : 1

Institution : SUA
Program of Study : BSBLS

3 : Contact and Address Details

Email : Mobile Phone : 0784175496

Street/Village : KAMBI YA RAHA Ward : MUUNGANO
Postal Address : 179, MANYARA - MBULU
District of Birth : Moshi Mjini Region of Birth: Kilimanjaro
District of Residence : Hai Region of Residence: Kilimanjaro

4 : Appellant's Basis of Appeal

I am appealing against :
1. Not Allocated Loan
I am appealing because :
1. Other Reason :

Created on 2021-11-10 12:10:39 page 1 / 3

6 : Attachments Checklist

You have attached the following evidences to support your appeal:

1. Birth Certificate of Appellant
2. Supporting letters and/or documents

Created on 2021-11-10 12:10:39 page 3 / 3

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