SOCIAL FRANCHISING ACCELERATOR - EXPRESSION OF INTEREST FORM
Please refer to all supporting information provided before filling out this form. If you have any
questions that are not answered in our FAQs please email khethiwe.cele@gsb.uct.ac.za. The
online form has to be completed in one sitting as it CANNOT be saved and completed later once it
has been opened. You may use this word version of the online to complete the questions, and
then paste them onto the online form here.
I: ORGANISATIONAL DETAILS
1. Organisation name:
2. Intervention name (if different):
3. Sector:
4. Key contact name and job title:
5. Physical address of main organisation:
6. Office/ mobile phone number:
7. Email:
8. Website:
9. Legal status of organisation:
10. Number of full-time equivalent employees:
11. Governance structure:
12. Registration number:
13. Date of establishment:
14. Organisation mission and objectives: Please provide a brief description of your organisation’s
social mission and objectives below. (100 words Max)
15. Has your intervention replicated? If so, how many times and how i.e. licensing, franchising,
wholly owned:
16. If not, have you ever been approached by those wanting to run your intervention in their area:
II: PROJECT DETAILS
17: Social Value: Please articulate how the intervention you are applying for support for creates
social change. In your description, please include the following elements: the social need being
addressed, who the beneficiaries are; the intervention’s main goals and the products and services
provided to achieve them. (350 words Max)
18: Social Impact: Please describe the outcomes and impact that your intervention has achieved
since it started, including key outcome and impact indicators, and the evidence you have to support
these. (200 words Max)
19: Business Model: Please detail the following aspects of your enterprise’s business model: (300
words Max not including the finance tables)
A. Please complete the following table for your organisation:
Company Performance
Information
Last FYE
(actual and forecasted)
Current FY
(forecast FYE
figure)
Next year
(Yr1)
forecast
Financial Year End (e.g. April
2012 to March 2013)
Income (R) (turnover)
Net profit before tax (R)
Net Profit after tax(R) /
Organisational surplus (if an
NGO)
B. Please complete the following table, for the specific intervention you are applying for support
with only. If your organisation only focuses on one activity (i.e. has one intervention) do not worry
about using the same figures for income as in the above table.
Intervention Performance
Information
(actual and forecasted)
Financial Year End (e.g. April
2012 to March 2013)
Income (R) (turnover) from
intervention
Last FYE
Current FY
(forecast FYE
figure)
Next year
(Yr1)
forecast
Intervention Net profit
before tax (R)
Intervention Net Profit after
tax(R) / Intervention surplus
(if an NGO)
Earned Income (% of
income)
Philanthropic income (% of
income)
C. Please list your current earned and philanthropic income sources that are higher than
R100,000.00 in value. State how secure these income sources are:
D. How are you different or more effective than other organisations working in your sector:
20: Commitment to scaling: Please give us an idea of your organisation’s commitment to scaling up,
and why social franchising is a good method to do so. Please include the points below: (600 words
Max)
A. Why your organisation/project wants to scale up its impact:
B. What are the current scaling goals? Please make these SMART (Specific, Measurable, Attainable,
Relevant, Time-bound):
C. Who may your franchisees be (i.e. what type of individual or organisation). Roughly, how many
are there across South Africa:
D. How might your franchisees be financially sustainable:
D. Why is social franchising an appropriate route to scale for your organisation:
21: Motivation and need for support: Please share your motivation for participating in the social
franchise accelerator, and why you feel the support offered by the accelerator will be of benefit to
your organisation’s goals and overall development. (200 words Max)
22. Would your organisation be interested in debt funding opportunities offered by other impact
investors or commercial investors?
o
Yes
No