2 Minute Pre-Assessment Form

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Email *

Full Name *

Phone number *

Phone number must be preceded by country code. E.g. +256xxxxxxxxx

Phone Number (2)

Phone number must be preceded by country code. E.g. +256xxxxxxxxx

Other Co-Founders:

Please add their names and contact details.

Name of venture? *

Where does the venture primarily work? *

Please give the town/district and country

Which Sustainable Development Goal are you primarily helping with? *

For more information about the SDGs, go to http://www.ug.undp.org/content/uganda/en/home/sustainable-development-goals.html

In one sentence, describe the problem you are solving. *

e.g. Most social startups fail before they raise any capital; there's been a huge amount of deforestation;...

In one sentence, describe your solution/product(s)/services(s). *

e.g. We offer coaching and training for early-stage social entrepreneurs; we manufacture eco-friendly cookstoves;...

In one sentence, describe your typical user. *

e.g. We target innovative social entrepreneurs who are typically between 20 and 35; we sell to farmers in Bukedea;...

As briefly as possible, describe what makes your product/service innovative. *

Describe how your product/service is unique/differentiated from competitors already in the market E.g. Providing virtual one-to-one vocational training workshops via Whatsapp, Uses new technology to recycle urban waste into construction material.

What year did you start your venture? *

In USD, how much financing (investment/grants/loans) have you raised for the venture? *

Is the venture registered as a legal entity? *

Yes

What stage best describes your venture? *

Pre-revenue (Yet to make a sale)

Post-revenue, Pre-Breakeven (Made some sales, but not enough to cover costs)

Post-Breakeven (Venture is making profit each month)

Please provide links to your website, social media pages, and/or other relevant sites.

For multiple links, please separate with a comma (,)

How did you hear about United Social Ventures? *

Privacy *

I approve storage, and usage of my data by United Social Ventures. My data will not be passed on.

Communications - I consent to receive communication by email and telephone. I understand I may opt out at any time using the unsubscribe link provided in all electronic communications.

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