Rosabon Registration Form
After you have filled out this form, a client services executive will contact you within 24 hours (working days) and 72 hours (weekend)
Location (State in Nigeria) *
Business owner or salary earner *
Please enter the product number
Name of Organization(For Salary earners) or Business name (For Business owners) *
For Business owners (Do you own a car that is within 2009-2019 model?) *
For Business owners and Salary Earners Who wish to access Asset Cash Loan and Rosabon Sole Proprietor Business Support (SPBS) Loan (Do you own a Landed Property with the Titled Document)
What platform did you get this link? *
Type of Product interested in *
Required
Monthly Net income (NUMBERS ONLY) *
Are you currently servicing a loan?(NUMBERS ONLY) *
if yes to above, how much are you paying back monthly? If No, indicate with 0.(NUMBERS ONLY) *
How much are you seeking to access?(NUMBERS ONLY) *
Type of (Salary) account *
Is Your Business Registered With CAC (Corporate Affairs Commission) *
IF Yes Kindly Pick *
Surname *
First Name *
Other Names *
Phone number (Primary) *
Phone number (Secondary) *
E-mail *
Official Email Address *
Preferred contact method *
Required
Questions and comments
Submit
Never submit passwords through Google Forms.
This form was created inside of The Concept Group.