YOUTH ENTERPRISE DIRECTORY: Youth Enteprises Registration Form

YOUTH ENTERPRISE REGISTRATION FORM

PART A: IDENTIFICATION

Enterprise / Business Name:
Registration No. :
Type of Registration :
Registered By :
Date of Registration :
VAT No. :
PIN No. :

PART B: PHYSICAL LOCATION

Building & Floor:
Street / Road :
Town / Village / Estate :
Physical Location :
Constituency :
County :

PART C: CONTACT PERSON & CONTACT DETAILS

Full Names :
Position Held :
Gender :
ID No. :
Email :
Tel / Mobile :
Address :
Website :
Level of Education :

PART D: NATURE OF BUSINESS

Form of Business:
Type of Business:
Products / Services :

PART E: FUNDING SOURCE / AGENCY

Funding Organization:
Date of Funding :
Amount Funded :
Nature of Funding :
Amount repaid to date (if loan) :

PART F: PARTNER ORGANIZATION

PARTNER 1

Name of Partner:
Role / Responsibility :
Contact Person :
Title of Contact Person :
Address :
Email :
Website :

PARTNER 2

Name of Partner :
Role / Responsibility :
Contact Person :
Title of Contact Person :
Address :
Email :
Website :

PART G

Have you been awarded contract by government?:

if YES

Government Department :

Contract Begun :

Contract End :

Value of Contract:

Financing of the Contract (Tick below as appropriate)

From Business Money:
Borrowing from Bank :
Self Savings :