Title: * Please select Mr. Dr. Prof. Alhaji Mrs
Full Name: *
Professional/academic background (e.g. engineering, financial, etc.): *
Phone: *
E-mail: *
Address: *
BUSINESS OVERVIEW
Company name: *
Country of Operation: *
Year your company began operations: *
Number of full-time employees: *
Short description of your business (including its key products and/or services): *
How would you characterize your company’s phase in the business lifecycle?: *
Concept, idea: *
Proof of concept, start-up phase: *
Operational, revenue generating: *
Sector: *
Description of Project: *
FINANCIAL OVERVIEW IN USD
Key partners, either operating or financial (e.g. investors or grant-makers, major clients, off takers, etc.): *
Last 12 months revenue, if operational: US$ *
How much capital are you seeking to raise?: US$ *
What will the capital be used for?: *
What form of capital are you seeking (e.g. debt, equity, grants)?: *
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