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Company name *
Do you meet the GDC’s eligibility criteria? *
- You sell beneficial household products that contribute to one of more of the Sustainable Development Goals
- You target underserved customers, who are low income and/or remote
- You are primarily focused on last mile distribution
- You sell through physical sales touchpoints, e.g., sales agents/retailers
YesNo
Primary contact – first name *
Primary contact – last name *
Primary contact – email address *
Country(ies) of operation, i.e., where you sell products to last mile consumers *
Category(ies) of products sold *Solar lights and home systemsCookstoves and cookersFuelsDomestic appliances, e.g., fans, TVs, radiosProductive use of energy appliances, e.g., solar water pumps, egg incubators, solar drip irrigation, solar millsAgriculture inputs, e.g., fertilisers, seedsWASH products, e.g., water filters, water treatment products, sanitary productsHealth products, e.g., medicines, contraceptivesNutrition products, e.g., fortified foods, vitaminsConsumer electronics, e.g., mobile phones, smart phonesOther
If other, please specify:
If you sell services, tick category(ies) that apply Crop insuranceHealthcareWaste removalSoftwareFinancialOther
If other, please specify:
Distribution channels used *Direct to consumers and/or through sales agents (whether employees or micro entrepreneurs)RetailersCommunity channels (e.g., schools, non-government organisations or churches)E-commerceOther
If other, please specify:
Annual revenue in USD * Start-upBelow USD 100,000USD 100,000 - 250,000USD 250,000 - 500,000USD 500,000 - 1millionUSD 1million - 2millionUSD 2million - 5millionAbove USD 5million
Year in which your company started operating *
How many consumers has your company reached since you started operating? *
How did you calculate this number? *
Is your company locally owned? i.e., citizens of the country of operation own >50% of the shares *
YesNo
Is your company locally led? I.e., citizens of the country of operation make up >50% of the senior leadership team or the CEO / MD is a citizen of the country of operation. *

YesNo
Is your company women led? i.e., women make up >50% of the senior leadership team or the CEO / MD is a woman. *
YesNo
Is your company women owned? I.e., women own >50% of the shares. *
YesNo
Company website *
Link to your company's LinkedIn Page *
Do you give the GDC permission to use your company logo and website on our website? *
YesNo
Do you agree to the GDC code of conduct? Read here *
YesNo