Funding Screening Form
Please complete this form and tell us more about your business
Email address *
What's your full name? *
Your answer
What is your company's full name? *
Your answer
What is your company's registration number *
Your answer
Where does your business operate? *
indicate the City, Province, and Country
Your answer
Please give a brief description of your business (max 3 paragraphs / 250 words) *
Your answer
How long has the management team worked together in this venture and/or other ventures? *
How many years of experience do you / your team have in this industry and/or product? *
How many people are in your management and daily operations team? *
How much Revenue is your business generating? *
Is your business profitable? *
What Industry is your business operating in? *
Required
What impact does your business have on society? *
Required
How much influence does government regulation (above general statutory requirements) have on your business? *
e.g. Role in Healthcare / Environmental impact / Science & Technology Support programmes / etc.
Your answer
Please provide any other information you deem relevant to your application? *
Your answer
Submit
Never submit passwords through Google Forms.
reCAPTCHA
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service