AfriMatch - Application for Matching, Finance, and Professional Services in the Motherland

1

Name of Applicant* This field is required.Even if there are more than one applicant - please enter a single point of contact

Prefix

First Name

Middle Name

Last Name

2

E-mail of Applicant* This field is required.This must be a monitored address

example@example.com

Email Verified

The verification code has been sent to some@email.com
Please check your mailbox and paste the code below to complete verification

••••

3

What is your business title?* This field is required.Founder, CEO, President, Director...

4

Business Phone Number of Applicant* This field is required.

Country Code

Area Code

Phone Number

5

Personal Cell Phone * This field is required.(We'll send you text reminders for our upcoming seminar)

Country Code

Area Code

Phone Number

6

Business Address of Applicant* This field is required.If you are a sole proprietor, this can be a home address

Street Address

Street Address Line 2

City

State

Zip Code

Country

7

Are you a black owned business? * This field is required.

YESNO

8

Do you own at least 51% of your black owned business?* This field is required.These loans are for people of African descent only. Do not continue this application if you cannot meet this threshold

YESNO

9

Would you like to be matched with an African or Diasporan Partner?You must be of African Descent.

YESNO

10

Would you like to be matched with Professionals?

YESNO

11

Do you already have an African Local Partner?* This field is required.Funding is for people of African descent only. Do not continue this application if you cannot meet this threshold.

YESNO

12

If you said yes to having an African partner, please describe their role?Choose from the list below.

Please Select Position type

13

Name of African Co-ApplicantEven if there are more than one applicant - please enter a single point of contact

Prefix

First Name

Middle Name

Last Name

14

E-mail of Co-Applicant* This field is required.This must be a monitored address

example@example.com

Email Verified

The verification code has been sent to some@email.com
Please check your mailbox and paste the code below to complete verification

••••

15

What problem does your business address?* This field is required.

16

What is the solution that your business provides?* This field is required.

17

What is your target market/customer?* This field is required.

18

Is your organization a nonprofit?* This field is required.We will send you additional information relevant to your nonprofit status

YESNO

19

What is your industry?* This field is required.Choose the industry from the list below that most closely describes your industry.

Click on the dropdown menu

20

What does your product provide? * This field is required.Choose the type of product you provide.

Click on the dropdown menu

21

Is your business a startup?It's ok, we fund startups all the way to companies that are growing and established

YESNO

23

How does your business make money?Describe the mechanism for which you generate revenue

Choose from the dropedown list

24

How far have your gotten? Please explain

25

Is your business in operation now?* This field is required.

YESNO

26

Are you looking to grow your business?* This field is required.

YESNO

27

Is your business making money?* This field is required.

YESNO

28

How many founders are on your team?* This field is required.Tell us how many founders there are including yourself.

Choose from the dropdown menu above

29

Tell us about your team!

30

How much money are you looking to raise?* This field is required.

31

How much capital have your raised?

32

How will you use this funding?

33

What is your website address?

34

What is your Twitter handle?

35

What is your Linkedin handle?

36

What is your business Facebook page name?

37

What is your Instagram handle?

38

I agree that the information herein is true and correct

Yes

39

I want to be masked.(Choose the category you want to be matched with (you can have more than one.)