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    Client Pre-Assessment Form: Grant Application

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    Anne Pena
    The document is a grant application form that collects personal and business information from potential clients. It requests details about the client's identity, contact information, educational background, employment history, and entrepreneurial experience. It also asks about their current or proposed business, including its description, funding needs, market, and skills/training required. The assessor uses this information to determine if the client should be approved for funding, referred for additional support, or rejected from the program.

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    © All Rights Reserved
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    Client Pre-Assessment Form: Grant Application

    Uploaded by

    Anne Pena
    67 views7 pages
    The document is a grant application form that collects personal and business information from potential clients. It requests details about the client's identity, contact information, educational background, employment history, and entrepreneurial experience. It also asks about their current or proposed business, including its description, funding needs, market, and skills/training required. The assessor uses this information to determine if the client should be approved for funding, referred for additional support, or rejected from the program.

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    Grant application form

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    Grant ApplicationForm

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    The document is a grant application form that collects personal and business information from potential clients. It requests details about the client's identity, contact information, educational background, employment history, and entrepreneurial experience. It also asks about their current or proposed business, including its description, funding needs, market, and skills/training required. The assessor uses this information to determine if the client should be approved for funding, referred for additional support, or rejected from the program.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    67 views7 pages

    Client Pre-Assessment Form: Grant Application

    Uploaded by

    Anne Pena
    The document is a grant application form that collects personal and business information from potential clients. It requests details about the client's identity, contact information, educational background, employment history, and entrepreneurial experience. It also asks about their current or proposed business, including its description, funding needs, market, and skills/training required. The assessor uses this information to determine if the client should be approved for funding, referred for additional support, or rejected from the program.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 7

    GRANT APPLICATION

    CLIENT PRE-ASSESSMENT FORM


    Branch
    Area
    Province

    Clients Reference No.:


    Clients Name:

    Assessor Name
    Position
    Date

    Outcome of the assessment Approved Referral Rejection

    Comment on Assessment
    (Assessor)

    Follow-up on Assessment
    Outcomes

    NYDA/ GRANT PROGRAMME


    PERSONAL PROFILE OF POTENTIAL CLIENT(S)
    1. Client Name and Surname: _______________________________________________________
    2. South African Citizen Identity Number: ______________________________________________
    3. Contact details: Home Telephone: ____________________ Cell: _____________________
    4. Fax Number: ___________________________________
    5. E-mail address: _____________________________________________________________
    6. Physical address: _____________________________________________________________
    ______________________________________________Postal Code: _____________________
    7. Geographic Location (Rural/Peri-urban/Urban) : ______________________________________
    8. Marital status: ____________________________
    9. No. of Children: No. of other family members you are currently supporting:
    10. Are you related to any NYDA staff or Board member? Yes No
    If yes, indicate who __________________________________________________

    Educational Information (Highest level of Education achieved):


    1. Highest standard passed: (e.g. grade R – Matric)_____________________________________________
    2. Tertiary education (e.g. certificate/diploma/Degree etc.:_______________________________________
    3. Please specify the field of study: __________________________________________________________

    Employment History:
    1. Are you currently employed? Yes No
    If yes, for how long?
    If no, indicate if you have any previous work experience? (Please explain) ________________________
    ____________________________________________________________________________________
    ____________________________________________________________________________________
    General Information
    1. The purpose for your visit to NYDA? (Intervention required)?
    ____________________________________________________________________________________
    2. Have you benefited from any NYDA funded services before? Yes No
    If Yes Please specify: __________________________________________________________________

    3. Are you willing to participate in the NYDA Business Development Support if assessed to be requiring them?
    Yes No

    If no, indicate why:____________________________________________________________________


    ____________________________________________________________________________________

    NYDA/ GRANT PROGRAMME Page 1 of 7


    Entrepreneurial Analysis
    1. Do you have a business Idea? Yes No
    No (if no, refer to EDP training, starting with awareness)
    Yes (if yes, follow the questions on the Start Up)

    2. Are you currently running your own business? Yes No


    No (if no, follow the questions on the Start Up)
    Yes (if yes, follow the questions on the Existing Business)

    3. Do you have business plan? Yes No


    Yes, (if yes, refer for evaluation)
    No (if no, refer for training)

    Start Up (client who has a viable business idea to start the business)

    1. Why do you want to start a business? ______________________________________________________


    _______________________________________________________________________________________
    _______________________________________________________________________________________
    2. Indicate the sector in which the business will be operating: _____________________________________

    3. Give a brief description of the idea in terms of :


    a. The type of business ____________________________________________________________________
    b. The need the business seeks to satisfy is ____________________________________________________
    _______________________________________________________________________________________
    c. The potential customers are ______________________________________________________________
    d. The business operate from _______________________________________________________________
    e. The product/service which the business develop are___________________________________________
    f. The service be rendered are_______________________________________________________________

    4. What amount of funding would you require for your business? R _________________________________

    5. Assess yourself against the following business feasibility requirements:


    a. What management skills/experience do you have to start the business?
    _______________________________________________________________________________________________
    _______________________________________________________________________________________________

    NYDA/ GRANT PROGRAMME Page 2 of 7


    b. What technical skills do you have to start the business?
    _______________________________________________________________________________________________
    _______________________________________________________________________________________________
    c. Have you identified potential customers? Yes No
    If yes, who are they ______________________________________________________________________________
    d. Do you have any funds to invest in the business? Yes No
    If yes, how much?________________________________________________________________________________
    e. Do you have any equipment to start the business? Yes No
    If yes, list them: _________________________________________________________________________________
    ______________________________________________________________________________________________

    Existing Business (operational business)

    1. Why did you start the business?__________________________________________________________________


    _______________________________________________________________________________________________
    _______________________________________________________________________________________________

    2. Indicate the sector in which the business is operating? _____________________________________________

    3. Give a brief description of the business in terms of :


    a. The type of business: ___________________________________________________________________________
    b.The need the business seeks to satisfy is to __________________________________________________________
    _______________________________________________________________________________________________
    _______________________________________________________________________________________________
    c. Who are the customers/ potential customers? _______________________________________________________
    d.Where is the business operating from? _____________________________________________________________
    e. What is the product/ service of the business? ________________________________________________________
    f. How is the product/ service delivered/ rendered? ____________________________________________________
    g. How long has the business been in operation? _______________________________________________________
    h.How many people are employed by the business? ____________________________________________________
    i. What is the estimated annual turnover of the business? _______________________________________________

    Existing Client Business Plan


    (for clients who have existing business plans, please assess the business plan using the tool provided)

    NYDA/ GRANT PROGRAMME Page 3 of 7


    Capacity Building
    1. What skills/ knowledge do you have about the business you want to start?

    2. Have you ever received Entrepreneurship training? (Yes/No)


    If yes, indicate the training you received and name of the institution. (E.g. financial management, project
    management, etc. and provide proof of the training received.)
    __________________________________________________________________________________
    ___________________________________________________________________________________
    ___________________________________________________________________________________

    0. Are you willing to attend the Entrepreneurship Development Training if required? ______________

    Recommendation :
    (see attached list of Entrepreneurship Development Programme Training Offerings)
    _______________________________________________________________________________________________
    _______________________________________________________________________________________________
    _______________________________________________________________________________________________
    _______________________________________________________________________________

    Client Signature: _________________________________ Date: ____________________________

    Assessor: ______________________________ Signature: ______________________

    Position: _______________________________ Date: _________________________

    NYDA/ GRANT PROGRAMME Page 4 of 7


    Entrepreneurship Development Programme Training Offerings

    Awareness (1-2 hrs) (Pre-start Up/ Start Up/ Existing Business)

    This intervention is the basis for any training offered by EDP. It covers the following:

    • Basic Entrepreneurship Skills


    • Characteristics of an Entrepreneur
    • Basic Business Requirements

    Start Up – 1 (3 days) (Pre-start Up/ Start Up)

    1. Module 1 - Demonstrate an understanding of Entrepreneurship and develop entrepreneurial


    qualities
    2. Module 2 – Identify, Analyse and select business Opportunities
    3. Module 3 – Write and Present a Simple Business Plan

    Course : Small Enterprise - Start Up (3-4 days) (Start Up/ Existing Business)

    1. Module 1 – Entrepreneurial Profile


    2. Module 2 – Research
    3. Module 3 – Legal Aspects
    4. Module 4 – Marketing Strategy
    5. Module 5 – Management Functions
    6. Module 6 – Costing & Pricing
    7. Module 7 – Finance Management
    8. Module 8 – Business Administration
    9. Module 9 – Business Plan

    Course: Business Planning Process (4 days) (Start Up/ Existing Business)

    1. Module 1 – What is marketing


    2. Module 2 – Determine the Financial requirements of the new venture
    3. Module 3 – Manage Finances of new Venture

    NYDA/ GRANT PROGRAMME Page 5 of 7


    4. Module 4 – Procedure – a business plan for new venture

    NYDA/ GRANT PROGRAMME Page 6 of 7

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