China Europe International Business School (CEIBS)Women Entrepreneurship & Leadershipfor Africa Programme (WELA)Application Form Personal Information Title Dr. Mr. Mrs. Ms. First Name Last Name Date of Birth Nationality Phone Number Email Address Business Information Do you currently own a business? Yes No Business Name Industry Number of Employees Years of Operation Professional Background Current Job Title Briefly describe your primary responsibilities Highest Academic Qualification / Most Recent Professional Certificate Motivation and Goals What motivates you to enroll in this programme? What do you hope to build or achieve by the end of the programme? Business Growth Stage At what stage is your business currently? Not Started Selling Just Starting Growing Slowly Growing Fast Mature, Stable Business Stable, Thinking of Expansion/Scale Expanding or Scaling Locally Expanding or Scaling Internationally Business Structure and Scalability Does your business have established structures? Yes No Is your business ready to scale? Yes Not Yet Personal Contribution What particular strengths or skills do you bring to the programme? How would you prefer us to communicate with you? By post By post By e-mail By e-mail By telephone By telephone Statement of Accuracy:I hereby certify that the information contained in this application is complete and correct to the best of my knowledge. Date: Applicant's signature (Please provide your full name): * Please keep us informed, should your contact information change during the application process. Upon submitting your online application, please email proof of your academic or professional achievements, your CV or professional profile, and a passport-sized or portrait photo to africaprogramme@ceibs.edu.