CBA Incubator Funding Application

Funding Application Form

The CBA is pleased to announce that funding requests are again being accepted from entrepreneurs and businesses with plans for development of local employment within the country of KENYA.

If you are interested in financial and coaching suport for the launch or expansion of your business, please complete the form below. Once we have reviewed your application and wish to proceed, we will contact you regarding details and other information required -- so watch your email for details!

Only INCUBATOR funding applications using this form will be accepted.
FORM INSTRUCTIONS

There are 3 pages to complete this form, you can start anytime. The form allows 24 hours (from the same browser) to finish - so you can leave your work and come back later in case you are missing some information.

Please hit the "SUBMIT" button on the last page just once - you will receive an email confirmation of your submission once it is sent.

All information will be kept confidential to CBA.

Thank you and be blessed as you develop your business plans!

CBA

NOTE: If you are using a public computer, then it is recommended to clear the browser cache when finished.

Personal Info
Full Name*

First Name Last Name
Address*

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
E-mail*
Confirm your e-mail*
Birth Date*

Month Day Year
Cellphone number*
At CBA, we take our financial transactions seriously and therefore request a credit report on each applicant. This information is kept in confidence, and is used only for the purpose of evaluating repayment ability of CBA Incubator Funding. For this reason, we request your National ID number.
Enter your Kenyan National ID number:*
Are you and your business based in Kenya?*
Please be sure to answer all of the above questions...
The application form will apear only after this is done.
We're sorry - at this time, CBA is only accepting Funding Applications from Kenya-based entrepeneurs for Kenya-based businesses.

Please click SUBMIT button below to be added to our mailing list for future notifications.

Thank you - CBA
We always like to have some insight into the character of the people we work with - if you have not previously taken the CBA Entrepreneur Quiz or forgot your results code, then click here to open the Quiz in a new window and take the quiz right now.

Alternatively, visit https://hipaa.jotform.com/32300918324850
Enter your entrepreneur quiz results code here:*
Check ALL statements below that apply to you*

I was a Compassion sponsor childI am a ChristianI attend church regularlyI graduated high schoolI graduated trade schoolI attend college or universityI graduated university
When will you / did you graduate?
What university are you attending / did you attend?
What was your major field of study?
Business Status & Info
What Industry(-ies) does your business serve*

AgricultureConstructionConsultingEducationFinance/InsuranceHealthIT/SoftwarePersonal ServicesProperty/RealEstateRetailToursimTransportation
Have you already started your business?*

YesNo
When did you start your business?
Are you starting this business alone?

YesNo, I will have partners to help start the company
List list the names of your partners, their field of study and year of graduation (1 per line)
When do you plan to start your business?
How much money have you already invested in this business?
Kshs
How much more money will you be investing in this next round with CBA?
Kshs
CBA Investment Estimates

enter all amounts in Kenya Shillings
What is the funding amount that you are requesting from CBA?*
max Ks. 200,000
What is the high-range investment needed from CBA into your business?
How many full-time equivalent persons do you expect to employ after 1 year?*
How many full-time equivalent persons do you expect to employ after 3 years?*
How many of these employees do you foresee to be family members or relatives?
Revenue Estimates

enter all amounts in Kenya Shillings
What is the estimated revenue in the 1st year of operations? Enter expected revenue for 2020 if your company is already running*
What is the estimated revenue in the 2nd year of operations? Enter expected revenue for 2021 if your company is already running*
What is the estimated revenue in the 3rd year of operations? Enter expected revenue for 2022 if your company is already running*
Profit & Loss Estimates

enter all amounts in Kenya Shillings, use a minus sign in case of loss (eg., -500,000)
What is the estimated profit in the 1st year of operations? In case of an existing company, enter expected profit/loss for 2020.*
What is the estimated profit in the 2nd year of operations? In case of an existing company, enter expected profit/loss for 2021.*
What is the estimated profit in the 3rd year of operations? In case of an existing company, enter expected profit/loss for 2022.*
Additional Information
In 100 words or less, give a short "elevator pitch" of your business*

0/100
In 50 words or less, please tell us why you are seeking CBA assistance*

0/50
Business Plan Documents

(optional)
OPTIONAL: Attach your 1-page BUSINESS CANVAS documebnt here...

Please submit your application only once, using your latest/final version.

If you have also prepared a full set of Business Plan documents, please do NOT submit those at this time - we will request those as needed if your 1-page BUSINESS CANVAS is interesting for CBA investment.
Document #1 (pdf, doc, dox)
Add any other comments you wish share with us in the space below:

0/100
Should be Empty:

Personal Info

Business Status & Info

CBA Investment Estimates

Revenue Estimates

Profit & Loss Estimates

Additional Information

Business Plan Documents