Be the Change Academy, Visakhapatnam, India

Free Business Skills & Enterprise Training to create Viable Green Business Plans

Application Form

  1. 1.    Personal Data
Mobile Phone
Email Id


Date of Birth Martial status Father’s Name* Father’s Mobile number*


  1. 2.    Education
Highest level of education
Are you employed? YES/No
If yes, current monthly income INR
Are you still studying? YES/No
If yes, give details University:


Exprected date of completion:Do you have a bank account?* Do you have any savings?*


  1. 3.    Business Experience
Are you currently running a business? YES/NO
If yes, details Date of incorporation:

Annual turnover, INR:

Nature of business:

Have you previously run a business?YES/NOIf YES, reason for failure


Details of any previous business training or business studiesName of institution:


Date of completion:


  1. 4.    Details of your NEW Business idea


1.Describe your business idea in not more than 200 words.









2. Why do you think you have a good chance to succeed in what you want to do? Is there anything different or unique about what you are doing?  (in less than 150 words)








3.Which of the following sectors does your business relate the most?
  • Energy
  • Healthcare
  • Agriculture/Rural technologies
  • Cottage/Handircrafts
  • Education & Services




4.How many jobs would you create in the first year after incorporating your business?


I,                      , confirm that the information and facts that I have given above are true. I also understand that the loaning activity of Be the Change Academy is a competitive process and being part of the training programme in no way guarantees the receipt of a loan.


Signature:                                     Date: