10,000 Women Application

Program Overview
10,000 Women is a global initiative supported by The Goldman Sachs Foundation that provides women entrepreneurs
around the world with practical business education, business advising, and networking. To date, the initiative has reached
over 10,000 women from 56 countries. Applicants selected for the 10,000 Women program in Kenya will receive a world-
class business education at United States International University-Africa and connections to a professional support
network.

Practical Business Education

Designed in partnership with Babson College, one of the top-ranked entrepreneurship schools in the world, the 10,000
Women curriculum focuses on practical skills in topics such as negotiations, marketing, and employee management that
can immediately be put into practice.

A Supportive Network of Advisors and Peers

Participants will receive one-on-one business advising and the opportunity to learn from other like-minded business
owners. Upon successful completion of the program, graduates become part of a growing 10,000 Women alumni network
and will receive ongoing access to learning and networking opportunities.

Access to Capital
The 10,000 Women program shows small business owners how to become more bankable and position themselves to
access appropriate sources and levels of small business funding and capital.

Program Dates
The 10,000 Women program is delivered over 14 days. An additional 18-20 hours out of class engagement will be
required (meetings, business advising, site visits and evaluations).

Criteria and Eligibility

10,000 Women is designed for business owners who are passionate about growing their business, creating jobs in their
communities and who meet these criteria:
 Key decision maker with senior leadership role (i.e. CEO, COO, President)
 Business has operated for at least one year
 Business employs at least 10 people
 Annual revenue between Kshs. 10 Million – Kshs. 500 Million.
 At least 20% of business owned by women

 Openness to accessing external capital to grow business

Women who hold an elected or appointed government position are not eligible for this program. Additionally, women who
are connected to political figures may not be eligible for this program.

Application Submission
Completed applications should be submitted electronically to the below email address. Please note that late submissions
will not be accepted. Upon submission of your application, you will receive an email confirmation. Candidates will be
notified if they have been shortlisted to attend a 20-minute interview.

Scholars Admitted to the 10,000 Women Program

Those who are admitted to the 10,000 Women Program will receive a partial scholarship and be required to pay a
tuition fee of Kshs. 30,333.00.

Completed application forms should be submitted to: [email protected]

Or you may drop off to: USIU-Africa Chandaria School of Business, CEED 10,000 Women Office, Ground Floor.

For additional information, please contact: [email protected] or 0730-116649/0730-116164.

APPLICANT INFORMATION
Surname (last name): Prior surname (if any): First name: Preferred name:

Country of citizenship: Type of identification: Identification number: Birthdate (day/month/year)

Home Address:

Primary Phone: Mobile: Email:

This application is an initial assessment designed to help us understand you, your business, and why you are interested
in the program. This information will be kept confidential.

Annual collective income earned by all household occupants (from work, financial investments, real estate, etc):

Do you currently hold an elected or appointed government position, or do you regularly interact with government officials
in a professional or personal capacity? Yes No

If so, please provide details about such position and/or interactions.

Education
Degree Institution Specialization Dates Completed?
(Including Country)

Language: English
Proficiency :
Speaking None Beginner Intermediate Fluent
Reading None Beginner Intermediate Fluent
Writing None Beginner Intermediate Fluent
Best description of your current employment situation:
I own/co-own a for-profit business I run an NGO I run a business and also work for someone else
How many businesses do you currently own or co-own?:

BUSINESS INFORMATION
Page 2 of 7
Company Name:
Company Address:

Work phone: Email: Website:

Please briefly describe the products or services the business offers.

Percentage of the business you currently own: ______% Year business was founded: __________
Please list any co-owners, their gender, and of their share If you did not found the business please explain how you
of ownership in the business: acquired ownership (i.e. inherited, bought), and in what
Name: _____________Gender:____ ______% year.
Name: _____________Gender:____ ______%
Name: _____________Gender:____ ______%
Name: _____________Gender:____ ______%
What are your titles, roles and responsibilities in your current business?

Are you a senior decision-maker of the business? Yes No

Do you work full time at the business? Yes No

Is the business registered with authorities? Yes No

How has your business been primarily funded over time? Personal Family money Bank or Institution

Have you ever applied for funding from a financial institution? Yes No

If no, are you interested in applying for funding from a financial institution? Yes No

If yes, were you successful in obtaining funding? Yes No

If yes, please list loan/investment size. _____________
If no, why were you unable to obtain funding? __________________________________________________________
Current Year Previous Year Next Year
(Projected)
Number of full time salaried employees at year end (permanent
employees who work, on average, 35 or more hours per week)
Number of part-time salaried employees at year end (permanent
employees who work, on average, less than 35 hours per week)
Number of temporary employees at year end (not permanent, hired
for limited periods of time including contract and freelance)
Annual Gross Revenue Kshs.
Net Profit Kshs.

Page 3 of 7
SHORT ANSWER QUESTIONS
1. What motivated you to start your business?

2. Briefly describe why you are interested in this program and what you expect to get out of it.

3. What are your five-year goals for your business? If you achieve your goals, what is your predicted annual revenue
and number of employees in five years?

Page 4 of 7
4. What are the primary factors or challenges within your control that limit the growth of your company?

5. Please use this space for any other information relevant to your application that you would like to provide.

6. How did you hear about the 10,000 Women program? Check all that apply.
 10,000 Women Program Alumni

 United States International University-Africa Alumni

Business or Women’s Associations:

 The Federation of Women Entrepreneur Associations (FEWA)
 Business Networking International (BNI)
 Kenya Association of Women Business Owners (KAWBO)
 African Women’s Entrepreneurship Program (AWEP)

Financial Institutions:
 Chase Bank
 Kenya Commercial Bank (KCB)
 CFC Stanbic Bank

Government:
Kenya National Chamber of Commerce and Industry (KNCCI)
East Africa Trade and Investment Hub

Page 5 of 7
Media:
 Newspaper/Magazine
 Website
 Radio
 Social Media
 TV

 Other:
Please describe:
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________

Page 6 of 7
 APPLICATION WAIVER

If I receive a 10,000 Women scholarship from United States International University-Africa I certify that I will accept the
following terms:

1. Except under extenuating circumstances, I agree to attend all classes and, when applicable, participate in
networking events, business advising and other program activities. As a general rule, participants may not miss
more than one class.

2. I agree to make every effort to complete all assignments on time and be a model student.

3. I agree to provide information about my business for up to the next 5 years. This may include completing surveys
and questionnaires and participating in interviews and focus group discussions. I agree that this information may be
provided to 10,000 Women and the Goldman Sachs Foundation to allow for the design of the best possible post-
graduation supports; my personal identify and personal information will be kept strictly confidential.

4. I confirm that the information provided in my application and during my interview was accurate to the best of my
knowledge.

5. I agree to release all persons or entities, including Goldman Sachs, Goldman Sachs’ affiliates and 10,000 Women
from any liability arising from requesting any information in connection with my application for or granting a 10,000
Women scholarship. I acknowledge that submission of this application does not guarantee receipt of a 10,000
Women scholarship

I understand that if I have deliberately provided false information or fail to meet the terms of the 10,000 Women
scholarship, I will have to forfeit the scholarship.

Print Full Name ________________________________________ Date _________________

Signature ________________________________________

Page 7 of 7