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Working Capital Application for MSMEs that need access to capital in the absence of acceptable collateral
1.
Please provide your name and email address so that we can get in touch with you on your application.
*
2.
What is the name of your business?
(Required.)
3.
Where is your business located?
City or parish:
Country:
4.
Where does your business operate from?
Your own home
Your own premises
Rented premises
5.
What is the legal type of your business?
Sole Owner
Partnership
Corporation
6.
What sector does your business operate in?
Agriculture
Agro-processing
Manufacturing
Wholesale/Retail
Tourism
IT
Services
Construction
Other (please specify)
7.
What are the main product(s) and or service(s) of your business?
8.
How long has your business been operating commercially?
Less than 2 years
2 - 3 years
3 - 5 yrs
5 - 10 years
More than 10 years
9.
How many employees does your business have?
1 - 3
3 - 9
10 - 20
21 to 99
10.
Do you currently operate a bank checking account?
Yes
No
11.
Do you use a credit or debit card for your business operations?
Yes
No
12.
What were your total sales in the past 12 months? (in $US)
13.
What % of sales are generated by your 3 largest customers?
14.
What is your current receivables balance? (in $US)
15.
What is your current payable balance? (in $US)
16.
What is the current balance of your total borrowings? (in $US)
17.
Have you been forced to resort to “pay day” type easy access, high interest rate short term financing?
Yes
No
18.
Does the business prepare Monthly Management Accounts (MMA) or Income and Expenditure Statement (IES)?
Monthly Management Accounts (MMA)
Income and Expenditure Statement (IES)
19.
Do you use a Point of Sale for your sales?
Yes
No
20.
What would be the amount of working capital needed per month? ($US)
21.
What would be the purpose of the desired financing?
Temporary working capital
Permanent working capital
Equipment capital
Upgrade and improvements capital
22.
How many additional employees would the business employ over next 12 months?
23.
What type of advisory services would your business need to facilitate its growth objectives?
Financial
Accounting
Marketing
Production
IT
Other (please specify)
Current Progress,
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