web viewword-of-mouth. flyers & brochures. industry/business networks. no. marketing is being...
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NAME OF BUSINESS
CONTACT PERSON
TITLE
POSTAL ADDRESS
PHYSICAL ADDRESSLOCATION OF OTHER BRANCHES (IF APPLICABLE)CONTACT DETAILS PHONE
CELL
EMAILWEBSITE
LENGTH OF TIME IN BUSINESS
REGISTERED COMPANY NAME
TRADING NAME
LEGAL STRUCTURE PROPRIETORSHIP CLOSE CORPORATION PARTNERSHIP
OTHER (Please specify)
INCOME TAX REF. NO.
VAT NO. (IF REGISTERED)NAME OF BUSINESS BANK ACCOUNT HOLDERBANK NAME
BRANCH
BRANCH CODE
ACCOUNT NUMBER
DESCRIBE YOUR BUSINESS OR SERVICE:
Type details here.
DESCRIBE THE UNIQUENESS OF YOUR PRODUCT/SERVICE VERSUS EXISTING PRODUCTS:
Type details here.
DESCRIBE THE ADVANTAGES AND DISADVANTAGES OF YOUR PRODUCT OR SERVICE
Type details here.
DO YOU HAVE ANY PATENTS, TRADEMARKS, COPYRIGHTS OR PROPRIETY TECHNOLOGY?
YES NO
If yes, please specify here.
IF IN BUSINESS FOR OVER A YEAR, PROVIDE MOST RECENT SET OF FINANCIAL STATEMENTS: YES NO
PROVIDE YOUR CASH FLOW PROJECTIONS FOR THE NEXT 12 MONTHS: YES NO
WHAT IS YOUR AVERAGE VALUE OF SALES?
Type details here.
HAVE YOU RECEIVED ANY FUNDING FOR YOUR BUSINESS TO DATE? YES NO
IF NO – HOW HAVE YOU BEEN FUNDING YOUR BUSINESS?
Type details here.
WHO ARE YOUR PRESENT AND FUTURE CUSTOMERS?
Type details here.
DESCRIBE YOUR TARGET MARKET?
Type details here.
WHO ARE YOUR COMPETITORS? HOW WILL YOU PROTECT YOUR PRODUCT, SERVICE OR TECHNOLOGY FROM YOUR COMPETITORS?
Type details here.
HOW ARE YOU CURRENTLY MARKETING YOUR BUSINESS?
WEBSITE ADVERTISING SOCIAL MEDIA
TRADITIONAL MEDIA WORD-OF-MOUTH FLYERS & BROCHURES
INDUSTRY/BUSINESS NETWORKS NO MARKETING IS BEING DONE
OTHER (PLEASE SPECIFY
Type details here.
HOW MANY EMPLOYEES DOES THE COMPANY HAVE EXCLUDING THE OWNERS?
MICRO (LESS THAN 5 VERY SMALL (LESS THAN 20)
SMALL (LESS THAN 50) MEDIUM (LESS THAN 200)
ATTACH CV OF KEY PERSONNEL AND INCLUDE A DESCRIPTION OF ROLES: YES NO
Type details here.
DO YOU HAVE A BUSINESS PLAN? YES NO
HAVE YOU DONE A FEASIBILITY STUDY FOR YOUR PRODUCT/SERVICE? YES NO
IF YOUR BUSINESS HAS BEEN IN OPERATION FOR MORE THAN 3 MONTHS, WHAT CHALLENGES HAVE YOU FACED? HOW DO YOU FORESEE THE ECITI INCUBATION PROGRAMME ADDRESSING YOUR CHALLENGES?
Type details here.
TICK AREAS WHERE YOU NEED MOST HELP
FINANCIAL MANAGEMENT
TECHNOLOGY SUPPORT
FUNDING SUPPORT
BUSINESS MANAGEMENT
LEGAL AND CONTRACTUAL SUPPORT
SALES AND MARKETING
PRODUCT COSTING
PLEASE ATTACH THE FOLLOWING DOCUMENT TO YOUR APPLICATION:
LATEST financial statements (IF TRADING FOR MORE THAN 1 YEAR) Projected cash flow statement for 12 months Valid tax clearance certificate Valid CIPC registration documents Business profile
I do hereby declare, certify and acknowledge my understanding that the Management of the Eastern Cape Information Technology Initiative – ECITI, solely and upon its discretion, has the right to decide which applications will result in admission to the ECITI incubator, that the Management’s decision in this respect is final and that ECITI may seek at its own discretion advice from other sources about the application.
I further declare, certify and acknowledge my understanding that if this application is successfully accepted, ECITI and the applicant will enter into discussions to develop an Incubation Agreement that sets out the services to be provided by ECITI and the milestones and responsibilities of the successful applicant, and that the application may be withdrawn by the applicant and that ECITI may revoke its acceptance decision for admission at any time up to the signing of that Incubation Agreement.
I further certify that the information provided in this application, including attachments, is true and correct to the best of my knowledge.
SIGNATURE
FULL NAME
POSITION
DATE
EAST LONDONT +27 87 373 0970 [email protected] B, East London IDZ Science and Technology ParkLower Chester Rd, Sunnyridge, East London, 5208
QUEENSTOWN T +27 45 838 1846 [email protected] Griffith Street, Corner Griffith & Owen St, ECDC Building, Queenstown 5320