840, Chief Ali Bin Naam Road, Mombasa, KE
accelerator@hazinagroup.co.ke
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Personal Information
Name
*
First
Last
Gender
*
— Select —
Male
Female
Age Group
*
— Select —
18 - 34
35 & above
Which county are you from?
*
— Select —
Mombasa
Kwale
Kilifi
Tana River
Lamu
Taita Taveta
Garissa
Wajir
Mandera
Marsabit
Isiolo
Meru
Tharaka-Nithi
Embu
Kitui
Machakos
Makueni
Ntandarua
Nyeri
Kirinyaga
Murang'a
Kiambu
Turkana
West Pokot
Samburu
Trans Nzoia
Uasin Gishu
Elgeyo - Marakwet
Nandi
Baringo
Laikipia
Nakuru
Narok
kajiado
Kericho
Bomet
Kakamega
Vihiga
Bungoma
Busia
Siaya
Kisumu
Homa Bay
Migori
Kisii
Nyamira
Nairobi
Contact Number
*
Email Address
*
Have you participated in any incubation / accelerator program before
*
— Select —
Yes
No
Name of the incubation / accelerator program
*
Business Idea Information
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Do you have a business idea? (Skip this section if you answered No)
*
— Select —
Yes
No
What goods or service will your business be offering?
Who will be your target customers?
What challenges do you think your target customers have?
When do you intend to start your business
— Select —
within 3 months
within 6 months
within 1 year
after 1 year
Please continue to the next step.
Goals & Expectations
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Why do you want to be an enterprenuer
*
What do you expect to gain from the program? (Tick all that applies)
*
Learn how to start and run my business.
Mentorship support from experienced entrepreneurs.
Networking opportunities with fellow entrepreneurs.
Linkage to markets to sell my products and services.
Funding support to start my business.
Linkages to external investors for growth capital.
Others (please specify in the box below)
Other expectations from Hazina Accelerator (if you ticked last box above):
Please continue to the next step.
Declaration & Fee
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There is a training fee of KES 10,000/= which you will be required to pay if you are selected in the program. To confirm your commitment and seriousness to participate in this valuable program, we shall require a commitment fee of KES 1,000/= out of the training fee to be paid when submitting the application. This fee shall be refunded back to the MPESA number provided if you are not selected to participate in the program (on or before 20th December 2025). The remaining balance shall be paid after being selected to participate and can also be paid in 3 monthly installments of 3,000/= each month. Please make the payment of 1,000/= commitment fee to the following account and paste the confirmation code in the box below: KCB M-PESA Paybill: 522522 KCB Account No.: 1264762917 For any assistance, please Call/SMS/WhatsApp us on 0784 247 815.
Enter MPESA Number:
*
MPESA Registered Name:
*
MPESA Transaction Code:
*