Social Impact Organisations Onboarding Form Organisation Details Organisation Name * Name*FirstLast Email* WhatsApp Number* Website Main Country that you are servicing*AfghanistanAlbaniaAlgeriaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCentral African RepublicChadChileChinaColombiaComorosCongoCongo (Brazzaville)Costa RicaCote d'IvoireCroatiaCubaCuracaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast Timor (Timor Timur)EcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFijiFinlandFranceGabonGambia, TheGeorgiaGermanyGhanaGreeceGrenadaGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiKorea, NorthKorea, SouthKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorth MacedoniaNorwayOmanPakistanPalauPalestinePanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint VincentSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth SudanSpainSri LankaSudanSurinameSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamWalesYemenZambiaZimbabwe Other Countries that you are servicing Profit or non-profit making *Non-profit makingProfit making - social enterprisesProfit making - ordinary businesses Social cause type (2 options max)*Animal wealfareChildren and youthConsulting services to NGODisabilitiesEducationElderlyEnvironmentEquality and JusticeFoodHealthHousingHumanitarian AidInfrastructure and EnergyPovertyWomenOthers: please specifyImpacted Audience DetailsRough estimates are acceptable if actual data isn't availableNumber of target audience benefited from your social causes 2022 2023 Gender (2023) by %MaleFemaleOthersTotal: 0/100 Age (2023) by %Below 1818 - below 3535 - below 6565 or aboveTotal: 0/100 Ethnicity (2023) by %Local citizensNon-local citizensTotal: 0/100 Monthly income (2023) by %No or low income* / getting social aidsMedian income*High income*Total: 0/100*We define low income as 60% below median. High income as 60% above medianService Quality DetailsRough estimates are acceptable if actual data isn't availableSocial Impact 2023 total operating expense of your company (US Dollars) 2023 total number of employees (including executives) 2023 admin cost as a % of total cost0 to <5%5% to <10%10% to <15%15% to <20%20% to <25%25% to <30%30% to <35%35% to <40%40% to <45%45% or above*admin cost refers to overheads that do not directly service target audience. Salaries of executives and front staff is NOT part of admin costsGovernance Do you have a board of directors?YesNo Will you regularly disclose your financial statements and update this service quality database on our platform?YesNo Have you hired an external auditor on your financials and/or social impactsYesNoEnvironmental Impact 2023 total electricity consumption for your operation (refer to utilities bills) 2023 total water consumption for your operation (refer to utilities bills) Sources of funding (rough estimates are acceptable) by %DonationsGovernmentFees on services providedSelf-fundingOthersTotal: 0/100Declaration and Consent We confirm that all funds we manage are legally obtained and that we strictly adhere to all applicable Anti-Money Laundering (AML) regulations. We are committed to maintaining compliance with these laws and have established procedures to monitor and report any suspicious activities. We agree to provide any necessary documentation to verify the legality of our funds.*Yes Business registration or license Audited financial statements *By clicking submit, you have accepted our Privacy Policy and Terms and Conditions. We adhere to the highest standards of data protection and comply with all applicable data protection laws and regulations.SubmitReset Get Started Fund and Create Social Impacts Through QLI
