Application for Aceli Technical Assistance

General Information

1. Please select which program you are applying for: *

Agribusiness Survive & Thrive delivered in partnership with AMI & WYLDE International: For business owners/managers of high-impact agri-SMEs whose annual revenues are between US$50,000 and US$250,000 with at least 2 years of business operations and teams of more than 2 people.

Business Consulting Support: For business owners/managers of high impact agri-SMEs whose annual revenues are between US$400,000 and US$5M. Aceli will contribute a maximum of $15,000 to the cost of the business consulting services.

Growth & Investment Program delivered in partnership with Technoserve: For business owners/managers of high-impact agri-SMEs whose annual revenues are between US$150,000 and US$500,000 with 7-25 employees.

2. Please review the requirements for your selected program below and check each box to confirm your business will be eligible to participate:

Time investment of at least 15 hours every month

Access to reliable internet

Completion of all 5 mandatory surveys and submission of baseline, monthly and annual metrics

Download and completion of core program tools in each phase

Attendance of all sessions pertaining to the program (i.e. learning labs, coaching and peer networking sessions )

Working with peers to problem-solve and brainstorm common business challenges

2. Please review the requirements for your selected program below and check the boxes to confirm that your business will adhere to each:

Share in the cost of implementation support (20-30%), the exact amount will be mutually agreed upon after the scope of work is determined and specified in the tripartite agreement to be signed with Aceli Africa and the Consultant

Ensure that sufficient time and access is granted to the Consultant for successful identification of areas of support and delivery of the TA

3. In which country is your business registered?

4. What is the legal name of your business?

5. What is the date of Incorporation/Registration? *

Must be operational for at least 2 years to be eligible.

6. Name of Business Owner/ Manager* *

First Name

Surname

7. Job Title *

CEO

Managing Director

General Manager

Other - please specifyOther - please specify

8. Email Address *

Enter Email

Confirm 8. Email Address *

Confirm Email

9. Mobile Number (include country code) *

KE (+254) UG (+256) TZ (+255) RW (+250)

10. Alternative Mobile Number

11. Link to business website (if applicable)

12. Business Address *

If you are human, leave this field blank.

Kenya / Rwanda / Tanzania / Uganda

General Information