First Name: Second Name: Last Name: Organization Name: : CR Number: : Phone: Email: What is the business sector? Beauty Centers Restaurants and Cafes Clinics and Pharmacies Food Products Other Has the business been in existence for more than 12 months? Yes No Do you accept payments via Mada, Visa, or MasterCard? Yes No Do you have financial difficulties? Yes No Financing Type POS Working Capital Financing Finance leasing For SME

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