ADVISOR SELECTION APPLICATION FORM
Application submission for Service Providers to be considered as part of advisory teams for SMEs under the Readiness Improvement Program
FIRM CONTACT DETAILS
(*means that field is compulsory required)
Name of institution
*
Your Company Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Business Phone Number
*
Please enter a valid current number in Rwanda.
Is your firm or any of its professionals the subject of any current or upcoming legal or regulatory misconduct action?
*
Yes
No
If yes, provide details of this action:
Summarize your response
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BUSINESS REGISTRATION DETAILS
Country of Business Incorporation
*
Rwanda
Other
Date of Business Registration
*
-
Month
-
Day
Year
Enter the date of business registration
Date of Business Commencement
*
-
Month
-
Day
Year
Enter the date of business commencement
Legal Structure of Business
*
Private limited liability
Public limited liability
Partnership
Sole proprietorship
Other
Business Registration Number
*
Tax Registration Number
*
RSSB Registration Number
*
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BUSINESS OPERATIONS INFORMATION
Type of Service Provider
*
Financial/Business Development/Management Consulting Services
Legal services
Audit/Accounting services
Other
Description of Nature of Business:
*
(50 words minimum)
0/50
Economic Sector of Expertise
*
Please Select
Agriculture
Industry
Services
Agriculture Sub-sector of Expertise
Export crops
Food crops
Fishing
Forestry
Livestock & livestock products
Other
Industry Sub-sector of Expertise
Mining & quarrying
Manufacturing - Beverages & tobacco
Manufacturing - Textiles, clothing & leather goods
Manufacturing - Wood & paper; printing
Manufacturing - Chemicals, rubber & plastic products
Manufacturing - Non metallic mineral products
Manufacturing - Metal products, machinery & equipment
Manufacturing - Furniture & other manufacturing
Electricity
Water & waste management
Construction
Other
Services Sub-sector of Expertise
Maintenance & repair of motor vehicles
Wholesale & retail trade
Transport
Hotels & restaurants
Information & Communication
Financial services
Real estate activities
Professional, scientific & technical activities
Administrative & support services
Public administration & defense; compulsory social security
Education
Human health & social work activities
Cultural, domestic & other services
Other
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FIRM EXPERIENCE – FINANCIAL /BD ADVISORS
Are you licensed by the CMA?
*
Yes
No
Are you a dealing member of the RSE?
*
Yes
No
Do you have experience in preparation of business plans?
*
Yes
No
Do you have experience in preparation of operations manuals?
*
Yes
No
Has your firm been part of a capital market transaction advisors' team
*
Yes
No
Client projects (Provide no more than 5 projects for each area of experience)
*
Client Full Names
Project Type
Date Completed (mm-dd—yyyyy)
1
Transaction Financial Advisor
Transaction Legal Advisor
Transaction Independent Accountant
Business Plan Preparation
Operations Manual Preparation
Accounting Manual Preparation
Financial Due Diligence
Legal Due Diligence
Board Governance Manual Preparation
2
Transaction Financial Advisor
Transaction Legal Advisor
Transaction Independent Accountant
Business Plan Preparation
Operations Manual Preparation
Accounting Manual Preparation
Financial Due Diligence
Legal Due Diligence
Board Governance Manual Preparation
3
Transaction Financial Advisor
Transaction Legal Advisor
Transaction Independent Accountant
Business Plan Preparation
Operations Manual Preparation
Accounting Manual Preparation
Financial Due Diligence
Legal Due Diligence
Board Governance Manual Preparation
4
Transaction Financial Advisor
Transaction Legal Advisor
Transaction Independent Accountant
Business Plan Preparation
Operations Manual Preparation
Accounting Manual Preparation
Financial Due Diligence
Legal Due Diligence
Board Governance Manual Preparation
5
Transaction Financial Advisor
Transaction Legal Advisor
Transaction Independent Accountant
Business Plan Preparation
Operations Manual Preparation
Accounting Manual Preparation
Financial Due Diligence
Legal Due Diligence
Board Governance Manual Preparation
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AUTHORISED REPRESENTATIVE INFORMATION
Authorized representative names
*
First Name
Last Name
Authorized representative email
*
example@example.com
Role in the Company
*
Role of the representative in the Company
Mobile Phone Number
*
Representative's Mobile Phone Number
You’re requested to attach a copy of CV of Firm Professional(s)
(you can add up to 3 copies - for firm professional 1, firm professional 2, firm professional 3)
Firm professional(s)
*
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