Propella ICT Application Form

APPLY TO THE PROPELLA TELKOM FUTUREMAKERS PROGRAMME 

We have slightly more the 40 questions to ask you, but it shouldn't take more than 20 minutes to complete. Let's get you started! 

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SECTION A : About you
First Name

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* 1. First Name

Surname

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* 2. Surname

Cellphone Number

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* 3. Cellphone Number

Alternative contact number

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* 4. Alternative contact number

Email adress

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* 5. Email adress

Address

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* 6. Address

City

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* 7. City

Province

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* 8. Province

Country

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* 9. Country

Are you based in Port Elizabeth: *Please note that the Propella Futuremakers Programme is only open to people who are living in Port Elizabeth whilst the programme is running (October 2017 - June )*

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* 10. Are you based in Port Elizabeth: *Please note that the Propella Futuremakers Programme is only open to people who are living in Port Elizabeth whilst the programme is running (October 2017 - June )*

Age

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* 11. Age

Home language

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* 12. Home language

South African citizen

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* 13. South African citizen

Do you have a disability?

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* 14. Do you have a disability?

How did you hear about us?

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* 15. How did you hear about us?

SECTION 1 Complete! That was easy ...... Telkom Futuremakers - Propella 2017
What is your highest level of education?

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* 16. What is your highest level of education?

If other, please describe: (140 character limit)

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* 17. If other, please describe: (140 character limit)

Are you currently employed?

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* 18. Are you currently employed?

Are you currently studying?

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* 19. Are you currently studying?

Have you previously participated in a Telkom Futuremakers program?

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* 20. Have you previously participated in a Telkom Futuremakers program?

If yes, please specify:

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* 21. If yes, please specify:

Are you currently on any other sponsored programme?

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* 22. Are you currently on any other sponsored programme?

If yes, please specify:

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* 23. If yes, please specify:

Have you started a business before?

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* 24. Have you started a business before?

Are you currently running a business?

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* 25. Are you currently running a business?

Is your business registered?

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* 26. Is your business registered?

If yes, please provide your CIPC registration number:

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* 27. If yes, please provide your CIPC registration number:

Company Registered Name:

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* 28. Company Registered Name:

B-BBEE Level:

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* 29. B-BBEE Level:

Is your company more than 51% black owned? *Please note that only businesses that are more than 51% black-owned can participate on the programme. White-owned business-owners may form JVs to participate, and the black owner must also be an active participant in the programme.

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* 30. Is your company more than 51% black owned? *Please note that only businesses that are more than 51% black-owned can participate on the programme. White-owned business-owners may form JVs to participate, and the black owner must also be an active participant in the programme.

Will you be bringing your partner/partners on the programme?

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* 31. Will you be bringing your partner/partners on the programme?

If yes, how many partners? * Please note that partners must be co-workers of the company (not staff).

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* 32. If yes, how many partners? * Please note that partners must be co-workers of the company (not staff).

Do you have any employees?

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* 33. Do you have any employees?

If yes, how many?

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* 34. If yes, how many?

SECTION 2 complete! You are almost there....
DISCLAIMER : As part of our ongoing encouragement and support for entrepreneurs, Propella will provide assistance where possible and type, duration and cost suggestion interventions are at the discretion of Propella. By clicking "Submit" I certify that the information supplied on this application is true and complete to the best of my knowledge. I understand that I am not guaranteed a place on any of the Entrepreneurial Development Programmes or any other products or services offered by Propella.
Is your business idea tech or tech-enabled business? * For example, SweepSouth is a tech-enabled business that allows individual customers to hire cleaners through their online platform, as opposed to a traditional centralised outsourced cleaning business such as Supercare.*

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* 35. Is your business idea tech or tech-enabled business? * For example, SweepSouth is a tech-enabled business that allows individual customers to hire cleaners through their online platform, as opposed to a traditional centralised outsourced cleaning business such as Supercare.*

Does your idea involve creating......(select all related)

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* 36. Does your idea involve creating......(select all related)

Describe your business/product/service in a tweet(140 character limit)

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* 37. Describe your business/product/service in a tweet(140 character limit)

What customer segment does your business/product serve?

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* 38. What customer segment does your business/product serve?

Your business/product is adresssing is a problem. How big is this problem? Why is it a problem worth solving?

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* 39. Your business/product is adresssing is a problem. How big is this problem? Why is it a problem worth solving?

You believe now is the right time to solve this problem. Why now? What are the current opportunities or technologies that make your solution possible?

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* 40. You believe now is the right time to solve this problem. Why now? What are the current opportunities or technologies that make your solution possible?

Who else is trying to solve the problem? Who are your competitors?

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* 41. Who else is trying to solve the problem? Who are your competitors?

How do you think this business/products will generate revenue? Is there more than one way it can make money?

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* 42. How do you think this business/products will generate revenue? Is there more than one way it can make money?

An entrepreneur takes initiative, takes risks and takes responsibility for seeing their venture succeed. One a scale of one to 10 ( one being "not entrepreneurial" , 10 being Elon Musk), how entrepreneurial are you?

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* 43. An entrepreneur takes initiative, takes risks and takes responsibility for seeing their venture succeed. One a scale of one to 10 ( one being "not entrepreneurial" , 10 being Elon Musk), how entrepreneurial are you?

How would you describe your technical ability and interest? (select all related)

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* 44. How would you describe your technical ability and interest? (select all related)

Write 3 words that would best describe yourself?

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* 45. Write 3 words that would best describe yourself?

Section 3 complete! You're Done :)...Thank you for your time. Good Luck!
By submitting the application form, you certify that the information supplied on this application is true and complete to the best of your knowledge. You understand that you are not guaranteed a place on the Propella Incubation programme or have any access to other products or services offered by Propella.

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