Embed Size (px)
Citation preview
1
Application for SE Outreach Accelerator Stockholm 2014
Do you want to make the world a little bit better? You may even sit on an idea on how to go about it! Do you have the ambition to make your idea financially sustainable? Are you ready to take the next step?
Apply to the SE Outreach Accelerator in Stockholm 2014 if you:
Have an idea targeting issues facing the developing world
Are passionate about your idea Have ambitions (and some idea) of making it financially sustainable Are able to commit fulltime to the 8 week program in Stockholm (April 21-June 13, 2014) Can fully participate in a program conducted entirely in English
(read/write/speak/comprehend)
All ages, backgrounds, nationalities, and citizenzenries are welcome to our 8 week accelerator program. It is not necessary to have a registered enterprise prior to the program, and both for-profit and not-for
profits are encouraged to apply. You do not need a current revenue stream or be able to show profitability prior to the program (but you need to be fully commiteed to become financially sustainable).
HOW TO FILL IN THE APPLICATION 1. Make sure that you have read through the eligibility criteria and FAQ on
www.se-forum.se/se-outreach-accelerator/ prior to filling out the application.
2. Download the PDF and save it to your computer.
3. Open the file with any PDF reader that allows you to interact with the file.
Answer all questions in the application to the best of your ability
o Do NOT try to edit text fields/questions/check boxes/margins
4. Answer by typing into text fields and checking boxes where appropriate
o Please adhere to the space given for answers
5. Enclose CVs and two references to the application form (more information on page 8)
6. Submit the completed form electronically via e-mail to [email protected]
no later than December 9th 2013. Write “Application SE Outreach Stockholm” in the subject line.
Note: Incomplete applications, applications submitted after the given deadline, and applications missing required documents will NOT be considered.
For more information and FAQ, go to www.se-forum.se/faqs/
SE Outreach Accelerator Stockholm 2014
2
BASIC INFORMATION
1 Name: 2 Gender:
3 Age: 4 Country of residence: 5 Country of origin: 6 Name of enterprise: 7 Website URL: 8 Is your enterprise
officially registered? (if no, go to question 9)
What year? Which country/countries?
9 How long have your been devoted to you
business idea/innovation?
10 Legal structure:
11 Which of the following best applies to your
enterprise? Choose one and
explain your choice
12 Current stage of your enterprise/social
innovation:
13 Which sector best applies to your
enterprise? (select more than one
if applicable)
14 Country of operations: Country(ies) you operate in today:
SE Outreach Accelerator Stockholm 2014
3
Country(ies) you aim to operate in the future:
15 Number of employees:
16 Financial information (current, NOT
anticipated. Specify for which 12-
month period you are providing figures for):
Annual turnover (sales of product/service): Profit/surplus:
17 How much capital have you attracted
since your inception? (including
technical/business support):
INNOVATION & FINANCIAL SUSTAINABILITY
18 Describe the challenge/problem you
wish to address:
19 Describe your social business idea (describe your product/service) and explain how it will address the problem:
SE Outreach Accelerator Stockholm 2014
4
21 Who are your customers (i.e. who
will pay for your product/service)?
22 What other alternative solutions exist to the challenge you wish to
address (if any)?
23 Explain how your innovation is different from other solutions
that already exist. Why are you better?
24 How do you expect to make a profit/surplus with your enterprise?
25 What is your estimated market size
of your product/service in
your target country?
SOCIAL IMPACT
26 What social impact have you had so far
(i.e. what social and/or environmental results
have you achieved)? (If you have not yet had
any social impact, skip to question 28).
SE Outreach Accelerator Stockholm 2014
5
27 Number of beneficiaries that have benefited so far from
your innovation? (if any)
Total: % of current beneficiaries who are women: Describe how they have benefited from your product/service:
28 Describe what social impact you wish to see
in the future.
29 Number of beneficiaries/individuals
you wish to benefit within the next five
years?
TEAM & ENTREPRENEUR
30 Describe your team, including yourself
(i.e. list all the key people in your
enterprise):
Name | Position | Responsibilities | Paid/Unpaid/Other – specify | Full-time/Part-time
31 Which of the following best applies to your current engagement
(choose one and quantify):
32 Which of the following best applies to you:
SE Outreach Accelerator Stockholm 2014
6
33 Do you have mandate to make executive
decisions?
34 There are many challenges and
problems in the world. Explain why you have
decided to focus on this particular problem
(as described in question18).
35 Describe your previous experience:
In your target country/countries? In the field/sector that your enterprise is operating (will operate)? With the business related aspects of running an enterprise (project management, business planning, strategy, financial management etc).
36 What is your level of proficiency in the
following areas:
Excel or similar PowerPoint or similar Word or similar
37 Describe your English proficiency:
38 What specific skill sets do you wish to
improve during the Accelerator program
(choose all that apply):
SE Outreach Accelerator Stockholm 2014
7
39 If selected to the program in Sweden for
two months, which actors and
organization would you like to meet
(other than the SE Forum staff, coaches,
mentors and fellow entrepreneurs)?
40 Select ONE answer that best applies to
you. My main objective with attending the
Accelerator program is to:
OTHER
41 Is there any other information you would like to add that has not been addressed above?
42 How did you hear about the program?
43 If selected to the program, would you
like to bring one of the key people on your
team (if you have any) so that you can go
through the program together? (Note that
both persons must be able to attend the
ENTIRE program).
Who (from question 30)?
Motivate your choice:
SE Outreach Accelerator Stockholm 2014
8
ATTACHEMENTS
44 List of attachments that you are sending
with your application form:
CV (Required for all team members listed in question 30) Two references (Required) 2 min video pitch where you present yourself and your idea (Recommended) 2 other documents supporting your application, such as draft business plan, annual report. (optional)
Please provide us with references that can give relevant input on you in relation to your enterprise. We need the following info: name, organization, website, phone-number, email and description of your relationship with this person.
SIGNATURE AND CONFIRMATION 45 By submitting this application, I certify that the information in this application form is
true and correct to the best of my knowledge and belief, and I authorize SE Forum to investigate all statements or other information contained in this application form and any attachments submitted with it, unless I have stated in writing to the contrary.
Company Name Applicants Name
Date
Please note that the application should be submitted electronically as a completed PDF.
Submit the completed application with attachments to [email protected]. You will receive a
confirmation of submission within 48 hours. Applications submitted after December 1st will not be
considered.
SE Outreach Accelerator Stockholm 2014
