Applicant Information

Your First Name (required)

Your Last Name (required)

Email (required)

Contact number(required)

Age

Gender
FemaleMaleOther

Municipality

Community

City

Province

Enterprise Information

Which one of the following sectors does your enterprise fall under?
AgricultureEnergyWater

Trading name of your enterprise.

CIPC Registration Number:

How long has your enterprise been in operation?
Less than 3 monthsBetween 1 year and 3 yearsMore than 3 years

What is the current annual turnover?

Are you currently part of any enterprise development programme or incubation? If so, please specify:

Team Composition and Partnerships

Name of business partner or another director of the enterprise:

Indicate number of team members or personnel:

Does the team have prior business experience? Yes/Non, if yes elaborate:

Do the team skills complement each other and is it beneficial for the business? Yes/No, if yes please mention the various skills

Does the enterprise have other partners or stakeholder besides other directors? Yes/No, if yes please mention partners

Gender Equality & Youth Empowerment

Does the enterprise prioritize women and youth? Yes/No, if yes please elaborate

Does the business ownership comprise of youth and women? Yes/No, if yes please elaborate

Job Creation Potential

Does the enterprise have potential growth to maintain existing jobs and create new ones?

Sustainable Development Goals

What Sustainable Development Goal does the innovation address?

Green and Climate Impact

Do your enterprise efforts or innovation contribute to reducing climate change effects? If yes, how is your enterprise contributing to reducing climate change effects?

Business Model

Short Description of your and service/products you offer (200 words max)

What problem are you solving with you innovation or solution?

Describe your value proposition?

Who are your customers?

Describe the innovation of your business model?

How does your enterprise create social, economic and environmental benefits or impacts?

Describe your innovation in relation to climate adaptation

How would the impact be measured?

Have you conducted market research? If so what were the results of the market research?

Do you have a minimum viable product?

Have you sold your products to some customers? Elaborate:

To what extend is your enterprise using low carbon technologies?

Motivation

Why are you applying for this programme? What do you expect to achieve during the programme and after receiving the support through the programme (300 words)?

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