Cycle 6 Si3 Application Form

UJIA Social Impact Investment Initiative (Si3)
Explanatory Notes
- THIS IS NOT A GRANT REQUEST
- Once you have submitted the short contact form, business plan and video you will receive a confirmation email
- For more information on UJIA Si3 please visit our website: https://si3.ujia.org/apply/
- Please direct any questions about the application form to si3@ujia.org or Gaby 0546405196
Application Process
- Submit Video Application
- If your application is relevant for the second stage of the process, we will invite you to submit application form and financials
- 10 minute Q&A with our initial screening committee
- If invited, pitch event with our investment committee
- Due Diligence calls
- Final Decisions
Contact Information
Name of primary contact for the application*

First NameLast Name
Email*
Telephone*

Area CodePhone Number
Cell

Area CodePhone Number
Organisation Details
Name of the organisation*
Website
(if applicable)
Organisation address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
CEO name (if different)
CEO email (if different)
Please upload the following matierals when submitting your proposal:
1. Your Business Plan or Revenue profit/loss for 2020/21 and projection for 2021/22
2. A 2-minute video answering the following questions;
  - Why did you set up this business?
  - What is your business model/product?
  - What stage is the business at (revenue generating/pre revenue/seed stage)?
  - How will you use the investment from UJIA Si3
(The video should be simple and can be filmed on your phone)
Your Business Plan or Revenue profit/loss for 2020/21 and projection for 2021/22*

Browse Files
Max file size 10, 854 KB. Accepted file types include: pdf, doc, docx, xls, xlsx, csv, Cancelof
Your 2-Minute Video

Browse Files
Max file size 80MB. Accepted file types include: wma, flv, wmv, avi, mov, mp4, Cancelof
Any additional relevant materials you wish to add

Browse Files
Max file size 20MB, Accepted file types include: pdf, doc, docx, xls, xlsx, csv, txt, rtf, html, zip, mp3, wma, mpg, flv, avi, jpg, jpeg, png, gif (you may upload multiple documents) Cancelof
If your files are too big, or you wish to provide a link instead (i.e. to a YouTube video) please type them in here
Should be Empty:

UJIA Social Impact Investment Initiative (Si3)

Contact Information

Organisation Details