STUDENTS LOAN APPEAL FORM (SLAF1)

Form #: S5071.0022.2020_2023_2024

1 : Personal Particulars
Surname : SEIFU
Other names : REHEMA SALIMU
Form Four Index # : S5071.0022.2020

2 : University Admission Details

Academic Year : 2023/24 Program of Study: BHRM
Institution: MNMA

3 : Contact and Address Details

Email : allyomar3005@gmail.com Postal Address: Box 6005, MKinga
Phone: +255659988297 ward: MARAMBA
District of Birth : Mkinga Region of Birth: Tanga
District of Residence: Mkinga Region of Residence: Tanga

4 : Appellant's Basis of Appeal

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5 : Applicant's Declaration

I SEIFU, REHEMA SALIMU hereby declare that all the information I provided through the Online Loan Application System,
part of which is contained herein, is true to the best of my knowledge and that,I am fully aware that legal action shall be
taken against me in the event that the information given by me is found to be FALSE or misleading.

Applicant's Full name: SEIFU, REHEMA SALIMU Date : _________________ Signature: _________________

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6 : Attachments Checklist

You have attached the following evidences to support your appeal:

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

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