SECTION I

Name:         Email:

Business Name:

1. Which of KIE services are you interested in?

KIE loan

Business Development Services

Sub-contracting Exchange

2. Nature of Business: (Please tick one)

Manufacturing        Restaurant Laundry   Engineering

Posho Mill    Carpentry Jua Kali     Other

If Other Please Specify:

3.Location of Business:

4.Brief Description of Business Activities you perform:

SECTION II

1. Are you a Kenyan Citizen?
   YES NO
2. Are you above 25 years of age?
   YES NO
3. Has your business been operational for the past 2 years?
   YES NO
4. Do you have 2 guarantors?
   YES NO
5. Do you have the business' running bank statements from the last 6 months?
   YES NO
6. Do you have an asset that can be held as security if you intend to borrow from KIE?
   YES NO

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