AFRICUNIA BANK/SPARCO BANK AGRICULTURE GRANT
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1. First Name: *
2. Surname: *
3. Middle  Name:
4. Phone Number: *
5. Email Address: *
6. Home or Office Address: *
7. Full Name of your next of Kin/relative and their phone number: *
8. Are you a farmer? *
9. What types of agriculture farm produce or livestocks will you produce? *
10. Have you opened bank account with https://africuniabank.com/register/64268C9F5E4D15A2 *
11. If yes, what is your AFRICUNIA BANK account number? *
12. From where or how did you hear about AFRICUNIA BANK/Sparco Bank grant?(Example: From New Dawn Foundation, Friends, Family Members, Online, Social Media) *
13. Do agree to sell at least 90% of your farm produce to AFRICUNIA BANK/Sparco Bank? *
14. How much grant do you want for your farming project:
15. I hereby solemnly declare that all information provided herein are true to the best of my knowledge and belief and that I authorise NEW DAWN HUMANITARIAN FOUNDATION to share this data to AFRICUNIA BANK /SPARCO BANK and thus indemnify them for any breach of my privacy and against any legal liability whatsoever for their actions. Any lie, misrepresentation of facts, falsehood, deception uncovered in the course of processing the grant application shall lead to my disqualification from the grant. I also agree that the final grant approval decision lies with AFRICUNIA BANK / SPARCO BANK Board of Directors. By clicking on "Submit" button below I have accepted these conditions. *
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