FUSE MEMBERSHIP APPLICATION FORM

Full Name Position Role Name of Social Enterprise Email Address Telephone Number (WhatsApp Preferred) Alternative Contact (if any) Region -- Select Region -- Central Uganda Western Uganda Northern Uganda West Nile Eastern Uganda District Type of Social Enterprise -- Select One -- Agriculture Agro-Processing Renewable Energy Education & Skills Training Health & Sanitation Services Handicrafts/Artisan Products Waste Management/Recycling Eco-Tourism/Community Tourism Construction/Civil Engineering Other (Please Specify) Year of Establishment -- Select Year -- Number of Employees/Team Members -- Select Range -- 1–5 6–10 11–20 21–50 50+ Legal Status Registered NGO Community-Based Organization Company Limited by Guarantee Sole Proprietor Other Primary Products/Services Offered Target Audience Women Youth Persons with Disabilities Refugees Others Annual Turnover -- Select Range -- Below UGX 10 million UGX 10M - UGX 50M UGX 50M - UGX 200M UGX 200M - UGX 500M Above UGX 500M Why would you like to join FUSE? Submit Application