APPLICATION FORM

National Health Incubator (NHI) 2021

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FILL YOUR APPLICATION IN ENGLISH

The purpose of this APPLICATION FORM is to assist us in understanding your business proposition and needs. All information will remain confidential. Please try to provide precise responses. The submission of this application is not a commitment or a guarantee whatsoever of financing/ investment by Accelerate Prosperity, the Aga Khan University and other partners.

WHO CAN APPLY

  • Producers:
    • Launch: Ideas or Startups with a Minimum Viable Product (MVP), a health technology and/or innovation, that has gone through the first customer test;
    • Growth: Existing businesses with good revenue streams aiming to grow the existing health technologies or innovation;
  • Adopters: Existing health service providers with revenue streams who are looking to adopt a new or an existing health technologies or innovation within their operations.

ASSESSMENT CRITERIA

Business Criteria

  • A unique and innovative business model with a potential for causing or contributing to positive economic and social transformation.
  • A clear market niche, sound target market and customer base.
  • Realistic competitive advantage in terms of price, quality and easy/ large access.
  • Strong revenue and profit models, potential for scalability and growth.
  • Strong value chain effect.
  • Impact potential.

Personal Criteria

  • Strong entrepreneurial traits, including (but not limited to) leadership qualities, risk taking, street smartness, ability to do more with less etc.
  • Coachable team, including (but not limited to) openness to advisory, learn, ability and openness to constantly iterate, adapt and evolve based on changing conditions, realities or assumptions etc.
  • Past experience in doing business, or as an employee in a similar industry, or subject matter expertise relevant to the product/ service.

APPLICATION and Selection Process

Following are the key steps in the application process:
Step 1: Application Shortlisting
Step 2: Interviews of Shortlisted Applications
Step 3: Business Training & Advisory
Step 4: Submission of Information Memorandum & Financial Models
Step 5: Pitch for investment
Step 6: Due Diligence of selected applicants.
Step 7: Investments for shortlisted businesses


DEADLINE: Deadline to Submit Applications: 11th October 2021

GENERAL INFORMATION
4- What is your current profession? (Choose one)
8- What is your business type?
9- What is the current status of your business?

10- Location of the business

12- Details of Business Partners

13- Do you have access to computer system?
14- Do you have access to reliable internet services?
BUSINESS INFORMATION
7- Is your business currently profitable?

8- Who are your 3 biggest competitors of your business? Please mention their company names & current location:

9- What were the actual sales and profits earned from your business in the last 2 years?

2019

2020

10- What are the estimated sales and profits of your business for the next 3 years?

2022

2023

2024

STRENGTH OF THE TEAM

11- Owners / Team Profiles

BUSINESS STRATEGY
PURPOSE OF INVESTMENT
16- Purpose of Investment Sought(Check all applicable)

17- How much have you already invested in your business idea? (in terms of cash, land, equipment etc.) Please mention the total amount of investment made in PKR

18- How much more are you and your partners planning to invest in your business?

19- Where did you learn about this opportunity?

DISCLAIMER:

By submitting this form, you agree to complete all future requirements of Accelerate Prosperity and the Aga Khan University. By applying for our services, you release and hold harmless the organizers, sponsors, judges, coaches, trainers and their families for all liability for any injuries, loss, damage and lawsuit of any kind in connection with our process.

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