Leadership for Growth - Nominating Manager Form

We appreciate your interest in Amani Institute’s award-winning Leadership for Growth program. The form will take approximately 7-10 minutes to complete. Once submitted, our team will contact you shortly to discuss the next steps. Please note that this is a paid-for program, and the nominating manager or organization will be required to pay a program fee of Ksh. 99,000 + VAT
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Email *
Your privacy is very important to us and we are committed to protecting your personal information at all times. By agreeing below, you consent to fill in this survey and provide data that will be used by the Amani Institute for internal use and only in an aggregated way and/or anonymously for any external use, donor reporting, and marketing purposes.
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1.  Company Name *
2.  Website of organization (if applicable)
3a. Your first name *
3b. Your last name (surname) *
4. Your role in the organization *
5. City you are based in *
6. Does the majority of your organization's income come from the sale of products and/or services, and/or private investment (either equity or debt)? *
Please provide estimated percentage of the amount coming from sales and private investment.
7. Focus of operation *
8. Stage of business *
9. Sector (if your sector is not listed, please share it in the following question).
If your sector is not listed, please specify your industry
10. Number of Years in Operation *
11. Number of full-time employees *
12. Number of managers *
13. Please list the name and role/title of the manager(s) you want to nominate for the program. *
14. Have managers from your organization previously participated in the program? *
If you answered "Yes" above, please specify how many.
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