Applicant Information

Your First Name (required)

Your Last Name (required)

Email (required)

Contact number(required)

Age

Gender
FemaleMalenon binaryOtherprefer not to say

Disability
YesNo

Province

Is your enterprise located in a township?
YesNo

Name of Township

What is your physical address?

Enterprise Information

Which one of the following sectors does your enterprise fall under?
Sustainable AgricultureClean EnergyWater purificationWaste ManagementSustainable Transport

Trading name of your enterprise

CIPC Registration Number:

How long has your enterprise been in operation?
Less than 6 monthsBetween 6 months and 3 yearsMore than 3 years

Business Model

Short Description of your innovation and services or products you offer and why you believe your product or business model is innovative?(200 words max)

What problem does your innovative solution address in your township or community, and how could your enterprise contribute to improving livelihoods in the area?

Have you secured any kind of IP rights? (copyright / trademark / patent)

What is the current annual turnover?

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

Is the enterprise your only source of income?
YesNo

If no, which sector do you work in?
Private sectorGovernmentNGOConsultancyOther

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/No, 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 your enterprise offer reskilling opportunities for current employees? Yes/No, if yes please mention the reskilling opportunities

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

Equality & Youth Empowerment

Does the business ownership comprise of youth,women or persons with disability? Yes/No, if yes please elaborate

Indicate number of women, youth and persons with disability:

Please provide a brief explanation of your value proposition?

Please provide a brief explanation on how you plan to diversify your product and customer base?

Who are your customers?

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

How does your enterprise create environmental benefits and how the impact will be measured?

How does your enterprise create social benefits and how the impact will be measured?

How does your enterprise create economic benefits and how the impact will be measured?

Growth Prospects

Please provide a brief explanation on how the enterprise will generate revenue?

Please provide a brief explanation on how your enterprise business model align with future market growth?

Could you provide a brief explanation of some of the challenges the enterprise faces in terms of growth and expansion and how you plan to solve the mentioned challenges?

Could you provide a brief explanation of how you plan to utilise the grant funding to help solve the challenge(s) faced?

Number of people currently employed in your enterprise?

How many people can your enterprise employ in the next 12 months given adequate resources and support?

Sustainable Development Goals

Which of the undermentioned SDGs does your enterprise address directly or indirectly?
No povertyZero hungerGood health and well beingQuality EducationGender EqualityClean Water and SanitationAffordable and Clean EnergyDecent work and economic growthIndustry, Innovation and InfrastructureReduced InequalitiesSustainable cities and communitiesResponsible Consumption and ProductionClimate ActionLife below waterLife on landPeace, Justice and Strong InstitutionsPartnerships for the goals

Ability to scale and replicate

Is your business model replicable and can it be easily implemented elsewhere? Yes/No, if yes please elaborate

Motivation

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

Any other information that you would like to share on how your business support communities in the area where it is operational?

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