Student Registration

Anyone with a high school diploma or GED who is enrolled in an accredited college or technical program in the Treasure Coast / Palm Beaches(1) area is eligible for an Iduka micro-loan up to $3,000. Iduka micro-loans are interest free and may be, in some cases, converted into grants. If interested to learn more, please fill out and submit this form.

(1) You may still register if you live or attend college outside the Treasure Coast / Palm Beaches. We will soon be expanding to other areas in Florida.

Important Disclosure: Currently only accepting applications and contributions from individuals residing in the state of Florida.
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Personal Information
First Name: *
Last Name: *
Street Address 1:*
Street Address 2:*
Date of Birth:	DD 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 MM JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC YYYY 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005
Note: If you are under 18 years of age a parent or guardian will have to sign Student Loan Agreement before we can process your Iduka Micro-loan.
City: *
State/Province: *
Postal Code/Zip Code: *
Country: *	Select USA
Telephone Number:
Email Address:
School Information
School:
Enrollment status:	Select Half-time or more Less than half-time Non-degree program
Major: *
Current Academic Year:	Select High-school senior College Freshman College Sophomore College Junior College Senior Graduate degree Post-graduate degree Non-degree certificate Other
Anticipated Graduation Date:	Month: Select JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC Year: Select 2010 2011 2012 2013 2014 2015
Current GPA:
Loan Information
Loan Amount: *
Loan Use: *
Office use
Repayment Term: GifterRepaid: dd 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 MM JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC YYYY 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 Date Posted: dd 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 MM JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC YYYY 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 Date Disbursed: dd 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 MM JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC YYYY 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015
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Submission of this information is not an application for credit, but allows Iduka to determine if you meet the minimum criteria to apply. Actual applications are subject to verification of identity, school enrollment and other application information.