Apply With us Please enable JavaScript in your browser to complete this form.Name *FirstLastPhone Number *Email *EmailConfirm EmailSkype usernameCity / Town *1. How did you hear about us? *If you heard about us through a specific organization, please specify...2. Are you the founder or one of the co-founders of the business? *YesNo3. What is the name of your business? *4. We are interested in the web presence of your business. Does your business currently have any of the following? *An active WebsiteFacebook pageTwitter handleLinkedIn group or pageother 5. In what year was your business founded? *6. Is your business 2 years and older? *YesNo7. Can your business absorb funding between 20,000$ - 1,500,000$ ? *YesNo8. Does your business employ 5 - 100 Persons? *YesNo9. What is the form of your business? *Limited LiabilityLimited by guaranteeSole proprietor Partnership 10. What stage of development best describes your business? *IdeationStart upGrowing business Mature business11. What primary sector is being impacted by your business's activities? *WATEREducation Agri-businessEnvironment and Renewable energyother 12. Do you have some specific profit margin in mind?YesNo13. What are the financial goals of your business?Cover costs Cover costs and earn some profit14. What annual profit margins would you be happy achieving on average? *0% - 5% 6% - 10%11% - 15%16% - 20%More than 20%15. Individuals can also have non-financial motives for launching new business. Does your business have the explicit intent of creating social or environmental impacts? *YesNo16. Which of the following impact objectives does your business currently seek to address? *Access to clean waterAccess to Financial servicesAgriculture productivity Community development Employment generationFood securityHuman rights protection or expansionPollution prevention and waste managementSustainable Land useAccess to education Access to information Biodiversity conservation Conflict resolution Energy and fuel efficiency Generate funds for Charitable givingIncome/productivity growthSupport for Women and girlsWater resource management Access to energyAffordable housingCapacity building Disease specific prevention and mitigation Equity and empowerment Health improvement Natural resource conservationSustainable energyOthers17. Describe the social / environmental problem your business is trying to solve.18. How is your product or service solving that problem?19. What is the demographic group of the primary beneficiaries targeted by your business's activities?20. What is the size of your beneficiary population? *Less than 5,000Between 5,000 and 50,000Between 50,000 and 500,000 Between 500,000 and 1,000,000 More than 1,000,00021. Does your business regularly track itself against any of the Impact Reporting Investment Standards? *YesYesNo22. What is your model (particularly, what is your product/service, your main revenue generating activities (up to 3) and your distribution channels)? *23. What is the current operational model of your business? *Production / ManufacturingProcessing / Packaging Distribution Wholesale / RetailServices Financial ServicesUnsure24. Who is your target customer? *25. Who are your 3 main competitors? *26. What are their main strengths and weaknesses? *27. What was your business's total earned revenue:(please do not include any philanthropic investments or donations in this amount)? *28. Profit is the income after all expenses and taxes have been deducted. Roughly speaking, what was your business's profit margin (as a percentage of total investment) for calendar year 2020? *29. How many people worked for your business? (please exclude contract workers who are not on the ' official payroll)30. Full-time employees?31. Part-time employees?32. Seasonal employees?33. Volunteers?34. How much did your business borrow / Need to borrow? 35. In calendar year 2020?36. Since founding?37. How much additional investment are you planning to secure for your business? ( in the next 12 months )In the next 12 months 38. Equity financing39. Debt financing40. Philanthropic support41. How much additional investment are you planning to secure for your business? ( over the next 3 years ) Over the next 3 years 42. Equity financing43. Debt financing44. Philanthropic support45. Founders46. Please provide the following information about Founder 1 listed above:47. What is the age of Founder 1?48. What is the gender of Founder 1?MaleMaleFemaleOthers49. What is the highest level of education of Founder 1?Primary LevelPrimary LevelO'LevelA'LevelBachelors DegreeMasters DegreeP.H.DOthers50. Why is your team uniquely qualified to run this company?51. Why have you chosen to apply to this program?52. What other potential benefits would you look for from Investment Readness programs that are not included in the above list?53. What other potential benefits would you look for from Investment Readness programs that are not included in the above list? *YesNo54. Which year did you attend that Investment Readness program? (Please enter the year that you started the program using numbers only. If multiple programs were attended, please enter the earliest year of attendance)55. Is there anything else you would like to add that has not been captured above?Submit Naalya, Central Rise Plot 511 - Kira Municipality P.O.Box 9792 Kampala +256752650042 | +256782605865 info@goldstone-ect.org FollowFollowFollow