Application Form

Give a brief description of the project/ purpose of the fund e.g Purchase of machinery, working capital, etc.

Has your business received any other financial support from the public or private sector within the last 3 years?

Do you have any Intellectual Property Rights, Copyright or Patents over any of your products, services or processes?

I, the undersigned; hereby acknowledge that the above-mentioned data, information and documents submitted to Kirkpatrick Wallis Investments are true, accurate and complete. I undertake to inform Kirkpatrick Wallis Investments in writing of any changes to such data, information and documents within 30 days from changes and to update them annually or whenever requested by Kirkpatrick Wallis Investments and agree that Kirkpatrick Wallis Investments may make any enquiries it considers necessary to progress this application.

Basic Information

Company Information

Business Type (please select)

Fund Request Information

Loan Term Period (10 years max)

Has your business received any other financial support from the public or private sector within the last 3 years?

Do you have any Intellectual Property Rights, Copyright or Patents over any of your products, services or processes?

Legal Representative Details

SELF DECLARATION

Application Form

Basic Information

Company Information

Business Type (please select)

Fund Request Information

Loan Term Period (10 years max)

Has your business received any other financial support from the public or private sector within the last 3 years?

Do you have any Intellectual Property Rights, Copyright or Patents over any of your products, services or processes?

Legal Representative Details

SELF DECLARATION

Attention