Home
 
Step 1
A - Personal Information
Surname *
First Name *
Middle Name
Nationality
Country of residence
Gender Male Female
Age 20-25 26-35 36-45 46-55 Over 55
Date of Birth Cal
Present Occupation
Position
Tenure
Description
Previous Occupations
No. Position Start Date End Date
1. Cal Cal
2. Cal Cal
3. Cal Cal
 
List 3 Adjectives to describe yourself
No. Personal Adjectives
1.
2.
3.
 
B - Contact Information
 
Correspondence Address
Residence Address
Residance Town/Village
Residence District
Telephone
Work
Home
Cell
Email Id *
   
How did you learn about Enrich Engage Enable, Northern Karnataka’s Social Entrepreneurship program? Please tick all that apply.
Internet TV Radio
Newspaper Local University Local Organization
Friends/colleagues  
  If other please specify:
 
 
How will you submit your application?
Internet TechnoServe Mumbai Office Deshpande Hubli Office
Mail Fax Courier
 
C - Social Enterprise Concept Information
 
In which social area does your market-based social enterprise concept focus?
 
 
Which of the following are you proposing?
New market-based social enterprise Expansion of an existing market-based social enterprise
Modification of an existing donor-based social enterprise
 
If proposing an expansion or modification of an existing social enterprise, please answer the following questions where applicable
Location of social enterprise
Village/Town
District
Name of Social Enterprise
Is it registered Yes No
Year it was founded
As what type of legal entity is the social enterprise registered?
 
If there is donorship funding, who are current donors?
No. Donors
1.
2.
3.
   
Percentage of the social enterprise you own %
Total sales revenues for 2008/7/6 Rs
Total profits for 2008/7/6 Rs
Number of employees at year end 2008
Average employee annual salary at year end 2008 Rs
Total value of business assets at year end 2008 Rs
 
Step 2
Read and upload Excutive Summary
Upload Executive Summary in Microsoft Word format.
 
Step 3
Review and accept the Participation Agreement and Certification
 
 
© 2008 Enrich-Engage-Enable | About Us | Photo Gallery | FAQs | Online Application | Expression of Interest Form | Download Brochure | Contact Us |