Name of Applicant:
Name of company (if applicable)
Company Registration Number (if applicable)
Company address (if applicable)
Telephone Number (land line):
Alternate Telephone Number (cell phone):
Email Address:
Number of employees (if applicable)
Turnover in the last year (if applicable)
BEE status (if applicable) / Level
Brief description of core business (if applicable) / e.g. manufacture and sell lollipops
Total Funds Requested:
Duration of project:
Text in BLUE colour represents guidelines only. Application has a maximum limit of 5 pages.
Application has a maximum limit of 5 pages. Incomplete application templates will not be considered, All sections of the application forms are mandatory.
Identify the sector into which the project falls: Mark with an XRenewable Energy / Advanced Manufacturing
Circular Economy / Energy Efficiency
Internet of Things (IoT) / Smart City Solutions
Identify the activity(ies) for which funding is sought: Mark with an X
Techno-economic evaluation studies / Prototype development/improvement
Sourcing of IP opinions/patent support / Production of market samples and/or testing
Refining and implementing designs / Conducting field studies
Support of certification activities / Piloting, scale-up & techno-economic evaluation
Detailed primary market research / Business plan development
Incubation support
Section 1: Project Description, Market Need & Solution
1.1 Concise description of the project:
a. Briefly describe the project (5-10 sentences). What is the overall/core purpose of the project? Phase of project and what is funding being sought for?
1.2 Problem/Market Need and solution:
a. State the problem/ market need that you are addressing?
b. Specifically mention the technology (product/process/ service) that either has been or still to be developed as the solution to your problem or market need.
c. List the groups of people who have this problem/need and are likely to pay to have it solved.
d. Provide a list of anyone you know with the same or similar offering to yours.
e. How is your solution better than similar or alternative offerings?
Section 2: Intellectual Property
IP Position:
a. Do you have patents or other IP protection in place that pertains to the project? If so, who owns the IP and what does the patent/IP protection cover?
b. If you do not own the IP, is there an agreement in place to use/ transfer the IP to your company?
c. Is there a strong likelihood that you will develop IP that is patentable? If so, briefly describe potential IP.
d. What do you see as the most difficult aspects for competitors to copy in your offering?
Section 3: Project Plan & Budget
a. Complete the table below:
Activities / Duration / Start and End Period / Deliverables / Budgete.g. Development of business plan / 3 months / Month 1- Month 3 / business plan completed / R
b. Please attach a brief summary of results on work already conducted on this project.
c. Provide information on prior funding received for this project (funder’s name, amount received and aspect of project funded)
d. Have you recently approached other potential business partners/funders for financial support? If so, what is the status of your application?
Section 4: Commercialisation
a. What further activities (beyond the activities listed in section 3 above) would be required before you can sell your offering?
b. How do you intend to get your offering to the market e.g. Do you plan to license the offering to another company or manufacture and sell yourself?
Section 5: Team
a. List the key members of the team involved in the project. Provide their qualifications and years of experience in that particular field.
b. If part of a consortium, list external partners and role/contribution to project
Section 6: Project Risks
a. List any technical and/or commercial risks pertaining to the project and state how these risks will be mitigated.
Potential Risk / Probability of Occurrence / Impact of Problem / Level or significance of Risk(Probability x Impact) / Cause / Planned Action /
E.g. Raw material supply delayed / 4 / 8 / 32 / Supplier shutdown due to industrial / Source alternative/backup suppliers
Section 7: National Benefits
How will your offering benefit South Africa and/or South Africans? Please consider the following, as appropriate to the proposed project:
Level and potential intensity of:
· economic impact e.g. contribution to GDP growth, increased taxation revenue, meaningful job creation, increased and value added exports, increased competitiveness of industrial sectors and lowered net intellectual property cost,
· increased highly skilled capacity and knowledge base and increased capabilities for technology innovation,
· social impact including improvement in quality of life, and poverty alleviation and the potential impact in lowering barriers to entry for other South African technology innovations.
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