Work in Progress! Concept Note

Business Name

<Date

DIRECTIONS:Completing and submitting the Concept Note is a mandatory first step in the Work in Progress! application process. Ensure that all questions are answered according to the guidelines stated throughout this form. The submission must be in English.

Once completed, upload the Concept Note to the application portal:

Once received, Shuraako will review and identify candidates that are most appropriate for the Work in Progress! business development training workshops.If you have questions about the program or have not received acknowledgement of submission within 10 business days, email .

1. Business

Business Name

2. Applicant & Authorized Representative

Name of Applicant/Lead Applicant
Gender(Check the appropriate box) / ☐Male
☐Female
Telephone
Telephone
Email
Email

3. Business Ownership and Management

3.1 Ownership

List all those who have an ownership stake in the business.

Name / # of Shares / % of Shares or Ownership

3.2 Management Team

List the key managers or staff members responsible for implementing the project or running the business, and their work and educational experience.

Name / Position / Relevant Work Experience / Relevant Educational Experience

3.3 Entrepreneur

In the text box describe:

  • Who you are and your motivation for starting your business

  • Why you would like to participate in Work In Progress! business development services

4. Financials

Please provide the following historical and projectedfinancial data (if exact figures are not available, use best estimates). All financials should be verifiable by accounts or other official documentation.

Historical and Projected Financials
2015 / Jan – June 2016 / July – Dec 2016 / 2017 / 2018
Revenue (USD)
Profit/Loss (USD)

5. Business/Project Overview

5.1 Products/Services

In the text box below, describe:

  • Products and/or service your business provides

  • Price (USD) of those products/services
  • How does it solve aproblem or address the needs of your target customers?

5.2 Operations

In the text box below, describe:


  • Activities that occur in the production and delivery of your goods and/or services

5.3 Market

In the text box below, describe:


  • The geographic areas you provide your products and services to
  • Your target market

5.4 Competitors

In the text box below, describe:

  • Who your competitors are

  • What is your advantage over your competitors and their product/service offerings?

6. Impact

In the text box below, describe:

  • The impact (both positive and negative) of your business on the natural environment

  • The impact (both positive and negative) of your business on society

7. Business Expansion / Project Description

7.1 Expansion / Project Details

In the text box below, describe:

  • Why you are seeking to expand or launch a new enterprise
  • What assets / services will need to be purchased for the expansion / new enterprise

  • How the assets / services purchased with the investment will increase production, revenue and/or profit

In the text box below, describe:


  • How the expansion / new enterprise will have a positive impact on the lives of women and/or youth

7.2 Expansion / Project Cost

Potential Investment Request ($)
*OwnerCash Contribution ($)
Other Sources of Financing
Total Project Cost (Cash) ($) (Investment + Owner Contribution)
**In-Kind Assets ($)

*A cash contribution of at least 30% of total project cost is recommended.

** In-kind assets contributed to the project. Different than assets purchased with Owner Cash Contribution.

8. Employment

Note: Permanent staff is staff that is employed for a total of six months or more throughout the year and temporary staff is staff that is employed for less than a total of six months throughout the year.

In the text box below, describe:

  • The types of permanent and types of temporary jobs that will be created with the expansion or new enterprise/project

  • The business’ approach to employing women and youth
  • Fill in the following table (employment definitions are listed on the following page):

Year
Before
Expansion/Project / After
Expansion/Project
2015 / 2016 / 2017 / 2018
Number of permanent staff
Number of female permanent staff
Number of youth permanent staff
How many of the youth permanent staff are women?
Number of temporary staff
Number of female temporary staff
Number of youth temporary staff
How many of the youth temporary staff are women?

Employment Definitions:

Permanent employees: employees who work for you 6 months or more in a year

Temporary employees: employees who work for you less than 6 months in a year

Permanent female employees: female employees who work for you 6 months or more in a year

Permanent youth employees: employees between the ages of 15-35 employees who work for you 6 months or more in a year

Temporary female employees: female employees who work for you less than 6 months a year

Temporary youth employees: employees between the ages of 15-35 who work for you less than 6 months a year

9. Business Development Services

In the text box below, describe:

  • How the business development services will you grow your business and create employment opportunities

  • Business development services that would be mosthelpful for you in expanding or launching a new enterprise

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