SME Co-Investment Partners (SCIP) Programme Registration Form

Borang Permohonan SME Co-Investment Partners (SCIP) Programme
SECTION A: Basic Eligibility Requirements
SEKSYEN A: Syarat-syarat Kelayakan Asas

* Mandatory Field / Medan Wajib
1. Company have fulfilled the definition of SME *
Syarikat telah memenuhi definisi PKS
2. Company is registered with Companies Commission of Malaysia *
Syarikat didaftarkan dengan Suruhanjaya Syarikat Malaysia
3. Company has at least 51% Malaysian equity *
Syarikat mempunyai sekurang-kurangnya 51% ekuiti Rakyat Malaysia
4. Company is in operation between 1 to 5 years *
Syarikat telah beroperasi antara 1 hingga 5 tahun
5. Company have exhibited evidence of market traction and revenue generation. *
Syarikat telah beroperasi di pasaran dan telah menjana pendapatan
SECTION B: Company Information
SEKSYEN B: Maklumat Syarikat

* Mandatory Field / Medan Wajib
1. Registered Company’s Name *
Nama Syarikat
2. SSM Reg. No *
Nombor Pendaftaran SSM
3. Date of Incorporation *
Tarikh Daftar Syarikat
The programme is only open to companies that has been incorporated between 1 to 5 years. *
Program ini hanya di buka kepada syarikat yang telah berdaftar dari 1 hingga 5 tahun sahaja.
4. Date of Operation *
Tarikh Syarikat Mula Beroperasi
The programme is only open to companies that has been in operation between 1 to 5 years.
Program ini hanya di buka kepada syarikat yang telah beroperasi dari 1 hingga 5 tahun sahaja.
5. Please state your equity shareholder. (Company's equity shareholder must be at least 51% Malaysian owned) *
Sila nyatakan ekuiti perniagaan anda. (Pegangan ekuiti perniagaan perlulah sekurang-kurangnya 51% rakyat Malaysia)

Holders Equity / Pemegang Ekuiti

Bumiputera *
 
Chinese *
Cina
Indian *
India
Others *
Lain - lain
Holding Company (If Any) *
Syarikat Induk (Jika Ada):
Foreigner (If Any) *
Milikan Asing (Jika Ada):
face

Total Equity

 

7. Is your company a Women Owned Company? (Women Equity of more than 51%?) *
Adakah syarikat anda Syarikat Milik Wanita (Ekuiti Wanita Melebihi 51%?)
8. Business Sector *
Sektor Perniagaan
9. Latest Annual Sales Turn Over *
Jumlah Jualan Tahunan Terkini
10. Latest Number of Full Time Employee *
Jumlah Pekerja Tetap
11. Business Size (As according to SME Definition) *
Saiz Perniagaan (Mengikut Definisi PKS)
12. Please Elaborate on Your Business Activities *
Sila Terangkan Tentang Aktiviti Perniagaan
Remaining: characters
13. Have your company undergo the SME Rating for Enhancement Programme (SCORE)? If Yes, please provide the result & year of rating *
Adakah syarikat pernah menjalani Program Penarafan Daya Saing PKS (SCORE)? Jika Ya, sila berikan keputusan penarafan bintang dan tahun penilaian
SECTION C: Company’s Profile Attachment:
SEKSYEN C: Lampiran Profil Syarikat

* Mandatory Field / Medan Wajib
14. Company’s Contact Person *
Pegawai Untuk Dihubungi
15. Designation *
Jawatan
16. Contact Person Email *
Emel Pegawai
17. Mobile No. *
Telefon Bimbit
18. Office Address *
Alamat Pejabat
19. Postcode *
Poskod
20. State *
Negeri
21. Office Email *
Emel Pejabat
22. Office Phone Number *
Nombor Telefon Pejabat
23. Office Fax No (If any)
Nombor Faks Pejabat (Jika ada)
24. Factory Address (If any)
Alamat Kilang (Jika ada)
25. Postcode
Poskod
26. State
Negeri
27. Factory Phone Number (If any)
Nombor Telefon Kilang (Jika ada)
28. Factory Fax No (If any)
Nombor Faks Kilang (Jika ada)
29. Company’s Website / Social Media Page *
Laman Web / Laman Sosial Syarikat
e.g.: http://www.smecorp.gov.my
30. Have the company received any grants or seed funding *
Adakah Syarikat Pernah Menerima Bantuan Geran atau Modal Permulaan
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31. Please provide details of funding received from private sector (For example: Venture Capital, Private Equity, Peer-to-Peer (P2P) Lending, Equity Crowd Funding - If Any)::

Sila nyatakan maklumat bantuan kewangan yang pernah diterima dari pihak swasta (Sekiranya ada).

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32. Please provide details of funding received from any Ministries or Goverment's Agencies (For example: Cradle, MTDC, SME Corp. Malaysia - If Any):

Sila nyatakan maklumat bantuan kewangan yang pernah diterima dari mana-mana Kementerian atau Agensi Kerajaan (Sekiranya ada)

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33. You are required to provide your company ‘Pitch Deck’ maximum 5 pages in PDF format by providing a downloadable link here (e.g: via Dropbox, Google Drive or others) *

Anda perlu lampirkan ‘Slaid Pembentangan’ sebanyak 5 mukasurat (maksimum) dalam format PDF, tentang keperluan menyertai program ini melalui pautan yang boleh dimuat turun: (Contoh: Dropbox, Google Drive dan lain-lain)

e.g.: https://www.dropbox.com/