ADVISOR SELECTION APPLICATION FORM

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

CityState / Province

Postal / Zip Code
Business Phone Number*
Please enter a valid current number in Rwanda.Format: 0000 000 000.
YesNo
If yes, provide details of this action:
Summarize your response

BUSINESS REGISTRATION DETAILS
RwandaOther
Date of Business Registration*

MonthDayYear
Enter the date of business registration
Date of Business Commencement*

MonthDayYear
Enter the date of business commencement
Private limited liabilityPublic limited liabilityPartnershipSole proprietorshipOther
Business Registration Number*
Tax Registration Number*
RSSB Registration Number*

AUTHORISED REPRESENTATIVE INFORMATION
Authorized representative names*

First NameLast 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)*

Cancelof
Should be Empty:

FIRM CONTACT DETAILS