Submit Application

1. Personal Information

Full Name *

Date of Birth *

Highest Education Level *

Years of Business Experience *

Personal Phone Number *

Personal Email Address *

2. Business Information

Business/Project Name *

Registration Status *

Business Location *

In South Sudan Outside South Sudan

State *

County *

Date Established (or planned) *

Size of the Team *

Nature of Business *

Business Contact (Phone/Email)

Brief Business Description *

3. Finance & Traction

Business Stage *

Established Business Startup / Idea Phase

Income (Past 6 Months) USD

Net Profit/Loss (Past 6 Months) USD

Lifetime Business Income USD

Lifetime Expenditure USD

4. Your Proposal

What kind of help do you need? (Select all that apply) *

Financial Mentorship Assistance in Operation Other

Estimated Time Help Needed By *

Justify why we should help you *

How will Kush64 benefit from your business? *

When do you expect Kush64 to see turnover/earnings? *

5. Documents & Consent

Please upload relevant documents in PDF, JPG, or PNG format. Max size 5MB per file.

Applicant Passport Photo *

Personal ID / Passport (Both Sides) *

Business Reg. Certificate (If Applicable)

Utility Bill (Proof of Location)

Latest Tax Returns (If Applicable)

I agree to Kush64's Terms of Service and processing of information, including the Privacy Policy. I confirm that all information provided is accurate to the best of my knowledge. *

Submit Your Project

1. Personal Information

2. Business Information

3. Finance & Traction

4. Your Proposal

5. Documents & Consent