Ghana StartUp Clinic Form

The Ghana StartUp Clinic seeks to empower and support 160 startups (ten participants per each region) in Ghana every year for the next 5years.

The project is being piloted from September 1, 2021 with ten startup businesses from Volta (3), Eastern (3), Central (3) and Greater Accra (3) regions.

Please complete the form. Deadline for Aplication is September 10, 2021

Name *

First

Last

Email *

Phone Number *

Sex *

• Male
• Female

Business Status *

• Registered
• Not Yet Registered

NB: Please, we are NOT only considering registered businesses. If your business is selected and in the case that your are not registered, the programme will help you register it.

Is your business a Sole venture of a group venture *

• Sole venture (you are alone)
• A group (you're two or more)

If you are a group, then list the goup members

Region *selectCentralVoltaEasternGreater Accra

This is where your business is based.

Which of these areas does your business fall? *

• Technology and Internet
• Agriculture & Agriculture Marketing
• Fashion & Design
• Real Estate, Constriction & Engineering
• Creative Arts & Artisan
• Health and Education
• Business Consultancy
• Media Business & Online Media

Give us a brief description of your business or organization *

What Services or programes do you provide *

In the case of Profit makring - Services, Social business (NGO, CBO etc) - Programmes

Why should your StartUp business be select? *

Please, your submission should be less than 1page.

How did you hear of us first? *

• Facebook
• Twitter
• Instagram
• Linkedin
• Online News Portal
• A friend
• Radio
• TV
• WhatsApp
• Google Search

Undertaking

• Yes. I have read the details of the project and I undertand that by submitting this form does not automatically qualify my business to be selected.

Submit