Impact Fund Follow-up

Date today

Business Details

Company Name:

Company Website if available:

Social media (enter links to current social media here) :

Attach images of Business in operation:

Maximum upload size: 2.1MB

Describe your target customer segment:

Number of current customers/users:

Estimated number of customers/users, interested in your product/service:

key suppliers:

key operational partners:

How do you sell your product/service (distribution channels):

Operations:

Please describe your company’s location and facilities:

Does your working space meet your current and future needs?

Describe any technology used in the operation of your business?

Describe any technological challenges:

Team/Organizational Structure

List members of the team, and explain the role of each member:

(attach short biography of each founding members- relevant experience and skills)

Upload team profile images of team:

Maximum upload size: 2.1MB

Current number of employees:

Estimated number of employees in the next 12 months:

Business Progress:

Please include a detailed summary of all milestones (targets) achieved since receipt of grant funding.

Have you made any amendments to your original business plan?

Yes

No

If yes, outline changes to Business Plan here:

Upload amended business plan, if available, here:

Maximum upload size: 2.1MB

Outline your planned work-activities for the next month of operation:

Target Milestones for the next 12 months:

Outline target milestones for the next 6-12 months (please include estimated completion dates for each milestone)

Describe any current or predicted challenges (e.g. environmental challenges, internal difficulties)

Financial Status:

Is your business already operating? *

Yes

No

Total monthly income : *

Total Monthly expenditure *

* include a breakdown of expenditure in the text box below

Estimated monthly income: *

Estimated monthly expenditure: *

Support and Training:

Do you have any training requirements?

Financial training

Business management training

Business mentoring

OtherOther

Please reaffirm your commitment to the following by checking the boxes:

Completing the requested follow-up reports as requested by the Impact Fund management team.

Communicating any needs and difficulties to the Impact Fund management team.

Adhering to the policies and procedures of the Impact Fund

Note: in case of any technical difficulty with uploading the documents to the form or submitting the form. Please contact the key members of the Impact Fund management team.

Impact Fund Follow-up

Monthly Progress Template

Business Details

Operations:

Team/Organizational Structure

Business Progress:

Financial Status:

Support and Training:

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