USSIA Online Membership Registration Form
1. Zone  *
2. Name of Enterprise  *
3. Business Owner(s)  *
4. Contacts
P.O Box: Town/Village:
Mobiles:  * Land Line:
Email Address:  * Physical location:  *
5. Enterprise Type corporate family limited other partnership sole proprietor   *
6. Number of employees/professionals
Male Employees
Female Employees
7. Does your enterprise train others?
Male Apprentices
 *
Female Apprentices
 *
8. Sector  *
9. Gender of Owner(s)  *
10. Business Start year  *
11. Did you apply for a business loan as start up?
12. Company banks
13. Registered business by Registrar-Companies   District   Municipality   Town Council   Sub county   *
14. Taxes paid(i.e VAT, Import duty, Excise duty)  
15. Company products/services
16. Machinery / Equipment used Powered   Manual   Both  
17. Raw materials used
18. Semi processed material used
19. List 3 major Technical problems
20. List 3 major Managerial challenges
21. What type of training does your enterprise require? Technical   Managerial   Other