Zidisha Microfinance New Member Recommendation Form

This form must be completed, signed and stamped by the leader of a legally recognized
academic, religious or social institution in the applicants community.
Name of Referring Official: _______________________________________________
Title of Referring Official: ________________________________________________
Mobile Phone Number of Referring Official: __________________________________
Institution of Referring Official: ____________________________________________
Address of Institution: ___________________________________________________
_____________________________________________________________________
Office Phone Number of Institution: ________________________________________
Name of Applicant: _____________________________________________________
Full Residential Address of Applicant: _______________________________________
_____________________________________________________________________
Recommendation Letter:
I hereby attest that I know the applicant referenced here well, and to the best of my
knowledge he / she is of good character and reputation, such that I sincerely
recommend that Zidisha Microfinance entrust him / her with a loan. In the event that
he / or she fails to repay the loan according to the agreed schedule, I agree that Zidisha
Microfinance may contact me, and I commit to providing mediation assistance in good
faith to help the applicant and Zidisha reach an agreement regarding repayment of the
loan. I understand that I am not making any financial guarantee by signing this letter.
Additional Comments:
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
Signature and Stamp: _____________________________

Date: ______________