AB4IR DIGITAL INNOVATION HUB APPLICATION FORM

Full name *

Multiple Choice *

You email address *

Name of Company *

Position in Company *

Company registration number *

Physical Address *

What numbers should we call? *

Website Address

Product offering *

What products/service does your company offer?

Stage of development *

Majority Shareholding *

Current no. of employees *

Number of years in operation *

Which province and area are you based? *

Do you have a business plan/Business Canvas? *

What skill set do you/partner have that are relevant to the business? *

TECHNOLOGY/PRODUCT/SERVICES *

Please provide more details of your business idea:

EXPECTED SUPPORT *

Please let us know how you want us to help you: