Application form - The Virtual PIDA Information Center

Instructions

Before you begin filling in this form, please note:

This is NOT a funding application. Neither you nor the eventual winner can expect us to disburse any financial aid directly. Furthermore, we cannot guarantee that you will receive financial support at the end of this.

You will need 30 minutes to complete and must be completed in one sitting
You are required to attach the following:

Business plan and/or
Financial model

Additional documents can be uploaded such as your business registration certificate, technical studies, or any other information. (optional)
You are required to provide us with the name, gender, and year of birth of your company's management team (and their approximate shareholding if they are owners),
By completing this form, you give us consent to the collection and processing of your data. Please request the permission of other members of your management team before including their data in this form.

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How do we contact you?

Name *

SURNAME *

Role in business *

Phone (please include your country's dialing code) *

Do you have WhatsApp ? *

Yes

No

WhatsApp 1

Yes, it's the one above

Yes, let me give it to you

WhatsApp (please include your country's dialing code)

Email address *

Confirm Email address *

Copy email address (This must be different from the above address. We use this as a backup in case the first one doesn't work) *

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Tell us about your business

Is your business registered at least 1 African country? *

Yes

No

Please attach the registration certificate

Maximum upload size: 134.22MB

Explain why not *

What is the name of your business? *

Country of incorporation (i.e., which country is the business registered in)

Does your company have business outside Africa? *

Yes

No

What percentage of revenue is outside Africa?

What percentage of staff are outside Africa ?

What is your main industry? (select one) * What is your main industry? (select one)

What other industries does your business impact? (select up to 5) *

Describe your business in less than 150 words *

Which of these does your business impact? (We’ll require a brief explanation for each selection) *

Digital technologies

Environment

Sustainable infrastructure

Trade

Digital technologies (in less than 150 words)

Environment (in less than 150 words)

Sustainable infrastructure (in less than 150 words)

Trade (in less than 150 words)

How many employees does the business have ? *

How much revenue (in USD) have you made in the past 12 months? *

Have you raised any finance in the past 24 months? *

No

Yes

Debt (in USD)

Grants (in USD)

Other (Please indicate the type of funding and the amount in USD)

Have you received any other (non-financial ) assistance in the past 24 months? *

Yes

No

Please explain

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Tell us about your management team (min 2 max 3)

Team member #1

Gender *

Female

Male

Year of birth *

Title * Title

First name *

SURNAME *

Role in the business *

This person is a shareholder *

Yes

No

Percentage

This person is a (co-)founder *

Yes

No

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Team member #2

Gender *

Female

Male

Year of birth *

Title * Title

First name *

SURNAME *

Role in the business *

This person is a shareholder *

Yes

No

Percentage

This person is a (co-)founder *

Yes

No

Add Remove

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Tell us about your current project

(i.e., the reason you want our help)

Describe the project briefly (i.e., what do you want to do?) *

Please attach your business plan and/or financial model (Only one file can be submitted here. You can submit others below. You must submit a business plan or financial model or both to have your application considered.) Upload *

Maximum upload size: 134.22MB

Do you have any other relevant attachments?

Yes

No

Up to 5 attachments

Maximum upload size: 134.22MB

Do you know how much funding you are looking to raise? (NB. This is NOT a funding application. We will NOT disburse funds to any applicants.) *

Yes

No

Quantum (in USD) *

In your own words (max 150 words), what do you want from us? (Reminder: This is NOT an application for financing. We will NOT give financial support to any applicant.)

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Capacity Building

We suggest you complete this short, 90-minute course ( https://online.atingi.org/enrol/index.php?id=67 ) before 31 August 2022. We may ask you to complete it before you progress to the next stage.

If you are ultimately selected, you will be offered some additional trainings. Which of the following is of interest to you? *

Business Plan + Pitch deck development

Marketing

How to speak to investors (practising your pitch)

Financial Modelling

Climate Indicator Development and Reporting / Climate Financing

Certifications and compliance: name specific certification(s)/standard(s)

Green recovery/green infrastructure

Digital Security for MSMEs

Other

Which of these do you need digitalisation support for your company’s internal business processes?

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Instructions

How do we contact you?

Tell us about your business

Tell us about your management team (min 2 max 3)

Team member #1

Team member #2

Tell us about your current project

Capacity Building

Is there anything else you would like to share with us? (max 1000 words)

Clarification or Assistance