Form

This form would take you around 20 minutes to complete.

Please read through the form before filling it out and compile all needed documents including your resume, pitch deck, pitch video and business model canvas to submit under the corresponding fields.

3. Email address*

4. Phone number*

5. Country of residence*

6. City of residence*

9. Level of education*

10. What is your nationality?*

11. What language do you speak?*

Please select one.

Any other languages?

12. Organisation name*

14. Is your role:*

Paid - Full time

Paid - Part time

Unpaid - Full time

Unpaid - Part time

Other (please specify)

15. Please provide your LinkedIn URL.*

If referral, please specify

If other, please specify

17. Please upload your resume.*

Docx, Pdf, Ptt, Jpg

18. Please provide your organisation website and social media URLs.

Other, Please specify

20. What stage is your organisation at?*

Very Early Stage (e.g. Pre-seed funding, prototype / MVP level, concept testing etc.)

Early Stage (e.g. Seed funds secured, concept validated with clients, etc.)

Growth Stage (e.g. Pre-series A funding, revenue generating, significant traction etc.)

Advanced Stage (e.g. Series A funds secured, close to break even or already profitable, etc.)

21. For how many years has your organisation been operational?*

23. Describe your organisation's business model (i.e. revenue-generating model, products, services, and target clients, etc.)*

24. Is your organisation financially sustainable?*

Yes, the organisation generates enough revenue to cover costs and generate profit

Yes, the organisation generates enough revenue to cover costs, but doesn't generate profit

Yes, the organisation has insufficient revenue-generation to cover costs, however relies on grants to survive

No, the organisation is not financially sustainable, however has sufficient capital to breakeven

No, the organisation is not financially sustainable and struggles to remain operational

25. Describe your organisation's contribution to the targeted social causes (i.e. mission, activities and target beneficiaries, etc.)*

28. Describe how your organisation can scale up regionally or globally (both in terms of business and social impact).*

29. In which country is your organisation registered?*

30. What is the type of licence?*

Business Licence

Non-profit Licence

Both

None

31. Please provide core management team profile descriptions (experience, role and added-value)*

32. Please upload the following documents:*

Please select all required documents and upload at once.

33. Describe why you are applying to the C3 Impact Accelerator Powered by HSBC and what benefits are you expecting from the experience?*

34. Please provide the link to a video of yourself describing your organisation's business model and social mission as well as the reason why you are applying to the C3 Impact Accelerator Powered by HSBC.

35. Anything else you want to tell us?

Please accept C3 Terms and Conditions (http://wegrowwithc3.com/terms-conditions/):

I confirm that I have read C3 T&Cs, that I understand them, and that I agree to be bound to them.*