What's your e-mail address? *
Date of birth? * DD 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 / MM 1 2 3 4 5 6 7 8 9 10 11 12 / YYYY 2021 2020 2019 2018 2017 2016 2015 2014 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1939 1938 1937 1936 1935 1934 1933 1932 1931 1930 1929 1928 1927 1926 1925 1924 1923 1922 1921 1920
What is you ID Number? *
What Nationality are you? * Afghan Albanian Algerian American Andorran Angolan Anguillan Argentine Armenian Australian Austrian Azerbaijani Bahamian Bahraini Bangladeshi Barbadian Belarusian Belgian Belizean Beninese Bermudian Bhutanese Bolivian Botswanan Brazilian British British Virgin Islander Bruneian Bulgarian Burkinan Burmese Burundian Cambodian Cameroonian Canadian Cape Verdean Cayman Islander Central African Chadian Chilean Chinese Citizen of Antigua and Barbuda Citizen of Bosnia and Herzegovina Citizen of Guinea-Bissau Citizen of Kiribati Citizen of Seychelles Citizen of the Dominican Republic Citizen of Vanuatu Colombian Comoran Congolese (Congo) Congolese (DRC) Cook Islander Costa Rican Croatian Cuban Cymraes Cymro Cypriot Czech Danish Djiboutian Dominican Dutch East Timorese Ecuadorean Egyptian Emirati English Equatorial Guinean Eritrean Estonian Ethiopian Faroese Fijian Filipino Finnish French Gabonese Gambian Georgian German Ghanaian Gibraltarian Greek Greenlandic Grenadian Guamanian Guatemalan Guinean Guyanese Haitian Honduran Hong Konger Hungarian Icelandic Indian Indonesian Iranian Iraqi Irish Israeli Italian Ivorian Jamaican Japanese Jordanian Kazakh Kenyan Kittitian Kosovan Kuwaiti Kyrgyz Lao Latvian Lebanese Liberian Libyan Liechtenstein citizen Lithuanian Luxembourger Macanese Macedonian Malagasy Malawian Malaysian Maldivian Malian Maltese Marshallese Martiniquais Mauritanian Mauritian Mexican Micronesian Moldovan Monegasque Mongolian Montenegrin Montserratian Moroccan Mosotho Mozambican Namibian Nauruan Nepalese New Zealander Nicaraguan Nigerian Nigerien Niuean North Korean Northern Irish Norwegian Omani Pakistani Palauan Palestinian Panamanian Papua New Guinean Paraguayan Peruvian Pitcairn Islander Polish Portuguese Prydeinig Puerto Rican Qatari Romanian Russian Rwandan Salvadorean Sammarinese Samoan Sao Tomean Saudi Arabian Scottish Senegalese Serbian Sierra Leonean Singaporean Slovak Slovenian Solomon Islander Somali South African South Korean South Sudanese Spanish Sri Lankan St Helenian St Lucian Stateless Sudanese Surinamese Swazi Swedish Swiss Syrian Taiwanese Tajik Tanzanian Thai Togolese Tongan Trinidadian Tristanian Tunisian Turkish Turkmen Turks and Caicos Islander Tuvaluan Ugandan Ukrainian Uruguayan Uzbek Vatican citizen Venezuelan Vietnamese Vincentian Wallisian Welsh Yemeni Zambian Zimbabwean Other
Where do you work, describe your role and how many hours a week? *
Which phase is your business in? * Ideation (You have a business idea you would like to develop) Scaling (You have an existing business and would like to grow and expand it)
Why are you interested in this program? *
Why do you want to start a business? *
In what industry are you planning on starting a business? *
Do you have a working background or experience in the work you want to pursue? Please explain more *
Do you have experience as a manager or have management experience? Please explain more *
Are you committed to working more than 40 hours per week on your business idea? Yes No Uncertain
What are your short term goals? *
Do you have structures in place to manage your time well, if so, what are they?
How are you currently supporting yourself and your family financially? *
What type of business do you have? *
How long has your business been operational? *
How many staff members are you currently employing? *
Do you have a data point with which you record sales? * Yes No
What is your current output? (Average monthly sales) *
In what way is the demand for your product or service growing? *
What kind of infrastructure are you currently using? *
What kind of infrastructure will you need in order to grow your business? *
How/ in what way would you like your business to grow?
What would you say are your strengths?
What would you say are your weaknesses?
What would you say are opportunities you have right now?
What are some threats against you?
What device do you use the most to access the internet? *
What do you spend most of your time on when you are online? *
What is your Facebook Handle?
What is your Instagram Handle?
What is your Twitter Handle?
How/where did you hear about the Innovation Hub Africa program? *
What do you expect to gain by completing this program? *
Describe a time you faced a difficult learning/working challenge. Describe what it entailed and how you navigated through it. *
Tell us about yourself, what is important to you? What do you enjoy doing? Where do you see yourself in 5 years? *
What is your most notable accomplishment to date at school, work &/or personal level *
Can you name one person in your world who would be willing to encourage and support you during this Program? How have they supported you in the past? *
