SBH Non-Financial Stimulus Support application

Please provide responses to the questions below

It is important that you answer ALL questions honestly to determine the best support for you and your business.

Question Title

* 1. Please complete the fields below

Full Name

Name of Business

Village

District

Island

Name on Business License

Business license number

Photo ID number (passport number / driver's license number / NPF id)

Email Address

Phone Number

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* 2. What business do you operate

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* 3. How many employees do you have?

Number of females

Number of males

Number of people with disabilities

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* 4. How many family members are currently supported by the business?
Please enter the number of people for each age group

	Number of Males	Number of Females	Number of People with disabilities
Number of dependants	Number of dependants Number of Males menu	Number of dependants Number of Females menu	Number of dependants Number of People with disabilities menu

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* 5. Which Bank holds your business loan account?

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* 6. How much loan did you receive?

$10,000 and below

$10,001 - $20,000

$20,001 - $50,000

$50,001 or more

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* 7. What is the status of business loan account?

Payments are in order and up to date

Account is in arrears

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* 8. If in arrears, what is the age of arrears?

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* 9. How much is the arrears? and How are you planning to pay your arrears?

Amount of arrears

Payment plan

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* 10. Have you used a mentor or a business coach before?

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* 11. How much did you pay for the service (mentoring / business coaching)

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* 12. Do you have proper accounts? (Financial statements: balance sheet, income statement and cash flow statement)

Yes

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* 13. Are you open to working with an accountant to organise your financials?

Yes

SBH Non-Financial Stimulus Support application

Please provide responses to the questions below

Question Title

* 1. Please complete the fields below

Question Title

* 2. What business do you operate

Question Title

* 3. How many employees do you have?

Question Title

* 4. How many family members are currently supported by the business?Please enter the number of people for each age group

Question Title

* 5. Which Bank holds your business loan account?

Question Title

* 6. How much loan did you receive?

Question Title

* 7. What is the status of business loan account?

Question Title

* 8. If in arrears, what is the age of arrears?

Question Title

* 9. How much is the arrears? and How are you planning to pay your arrears?

Question Title

* 10. Have you used a mentor or a business coach before?

Question Title

* 11. How much did you pay for the service (mentoring / business coaching)

Question Title

* 12. Do you have proper accounts? (Financial statements: balance sheet, income statement and cash flow statement)

Question Title

* 13. Are you open to working with an accountant to organise your financials?

* 4. How many family members are currently supported by the business?
Please enter the number of people for each age group