1. Personal Information

Full Name *

Date of Birth *

Nationality *

Country of Residence *

Phone Number *

Email Address *

2. Identification

ID Type *
National IDPassportDriver's LicenseVoter Card

ID Number *

Expiry Date *

3. Investment Details

Amount to Invest *

Preferred Currency *
EURUSDGBPLocal Currency

Investment Frequency *
One-TimeMonthlyQuarterly

Investment Horizon *
Under 1 year1–3 years3–5 years5+ years

Primary Goal *
Savings GrowthEmergency FundFuture IncomeEducation

4. Income & Employment

Employment Status *
EmployedSelf-EmployedInformal SectorUnemployed

Monthly Income Range *
Below €500€500–€1,000€1,000–€2,500Above €2,500

Source of Funds *
Salary / WagesBusiness IncomeSavingsRemittance / Family

5. Access & Preferences

Preferred Communication
SMS/WhatsAppEmailPhone CallApp Notification

Do you use mobile banking?
YesNo

Preferred Statement Format
Digital (Email/App)Printed

6. Referral

How did you hear about us?
Community OutreachFriend/FamilySocial MediaWebsite

Referral Name / Code

Declaration

I confirm that the information provided is accurate and complete. I agree to the Terms & Conditions and Privacy Policy.

Signature (Type Name)

Date