Entrepreneurship Funding Program offered by HRH PRINCESS BELLE RACHEL FOUNDATION Application Form Gender *First Name *Last Name *Date of Birth Nationality Phone number Email Address *Address Address Line 1Address Line 2CityState / Province / RegionZip / Postal CodeAfghanistanÅland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelauBelizeBeninBermudaBhutanBoliviaBonaire, Saint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongo (Brazzaville)Congo (Kinshasa)Cook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyIvory CoastJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKosovoKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoNorth MacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorthern Mariana IslandsNorth KoreaNorwayOmanPakistanPalestinian TerritoryPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarReunionRomaniaRussiaRwandaSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint Martin (French part)Saint Martin (Dutch part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSan MarinoSão Tomé and PríncipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia/Sandwich IslandsSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited Kingdom (UK)United States (US)United States (US) Minor Outlying IslandsUruguayUzbekistanVanuatuVaticanVenezuelaVietnamVirgin Islands (British)Virgin Islands (US)Wallis and FutunaWestern SaharaSamoaYemenZambiaZimbabweCountryOrganization / Business Name Website / URL What is the current stage of your project/business? *IdeaStart-up (under 2 years)Established (2+ years)Purpose of Funding (check all that apply): *Product DevelopmentMarketingEquipment Hiring Other Amount of Funding Requested Brief Description of Your Business (Max 200 words) Describe How You Plan to Use the Funds: (Max 300 words) Estimated Total Project Budget Your Contribution (if any) Which sector(s) does your business fall under? (tick all that apply) *Agriculture HealthEducationDigital / TechnologyDigital / TechnologyCreative industriesNon-profit/ NGOOther What problem are you addressing? *Who are your target beneficiaries or customers? *What are the expected outcomes / impact of your project? (100-150 words) *Have you received prior funding or support for this project? *YesNoIf yes, please give details How will the project be sustainable beyond the initial support period? (100-150 words) *Please list two key performance indicators (KPIs) you will use to measure success *Are you applying as an individual or as part of a team/organisation? *IndividualTeam Organisationis the organisation registered? YesNoIf yes, registration number Brief background of your team/organisation (100-150 words) *Business Plan / Pitch Deck * Drop your file here or click here to upload You can upload up to 1 files. Financial Statements or Projections * Drop your file here or click here to upload You can upload up to 1 files. Proof of Business Registration (if applicable) Drop your file here or click here to upload You can upload up to 1 files. Any Additional Supporting Materials Drop your file here or click here to upload You can upload up to 1 files. Attachments (tick what you’re submitting) Business Plan / Pitch DeckFinancial Statements or ProjectionsProof of Business Registration (if applicable)Any Additional Supporting MaterialsCopy of IDOther Is there anything else you’d like us to know about your project or you as applicant? (max 150 words) List any organizations, clubs, volunteer work, or community service you participate in (optional) How, where, or from whom did you hear about our foundation? *Declaration *I hereby declare that the information provided above is accurate and complete. I understand that providing false or misleading information may result in disqualification. I give permission to HRH Princess Belle Rachel Foundation to collect and store the submitted data and to verify the information provided. I consent to the processing of my personal data for application and coordination purposes. I agree to abide by the HRH Princess Belle Rachel Foundation’s policies, values, and code of conduct.Date / Time *Signature (Full name) *NameSubmit
