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* 1. Address

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* 2. Tell us about your social enterprise product or service (Max 150 words)

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* 3. How long have you been operating? 

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* 4. What is the social/environmental impact you are seeking to achieve? How will this impact be achieved? (Max 100 words)

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* 5. Tell us about a success you have had in building you social enterprise

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* 6. Tell us about a challenging time/event in your enterprise development and how you approached this (Max 50 words)

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* 7. Why are you seeking investment, what purpose does it serve?

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* 8. Have you received any investment to date?

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* 9. Please upload your enterprise budget 

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* 10. What are you looking for from a mentor? i.e Are their any specific skill sets or areas of expertise you are looking to tap into through mentoring?

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* 11. I acknowledge that by submitting this application I am willing and able to commit to the program dates outlined in the Kick Starter brochure and online. 

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