ENTERPRISE M3 FUNDING ESCALATOR

Pre-application Form

COMPANY DETAILS
Company Name
Company Registration Number
Company Date of Incorporation
Company Address
Company Directors
External Advisors
Name + Contact details
COMPANY CONTACT DETAILS
Name / Position
Telephone / Mobile
Email / Website
FUNDING REQUIREMENT
Total funding required (£)
Total to be raised in this funding round
Other/External funding (£)
If applicable. Please specify amount(s) and source(s) and status of availability/negotiations
Proposed use of loan
Please specify how the money borrowed from the Funding Scheme will be spent
FINANCIAL SUMMARY
Historic Financials (if applicable): / Year -2 / Turnover £ / Net Profit £
Year -1 / Turnover £ / Net Profit £
Current Financials : / Year to Date Actual : X months / Turnover £ / Net Profit £
Full Year Forecast / Turnover £ / Net Profit £
Forecast Financials : / Year +1 / Turnover £ / Net Profit £
Year +2 / Turnover £ / Net Profit £
Year +3 / Turnover £ / Net Profit £
BUSINESS OVERVIEW
Primary Activity / Please briefly describe your main business activity, service or product + its competitive advantage and any Intellectual property rights.
Progress to Date / Please state how the business has been funded so far. Briefly describe the track record/achievements to date + current status/scope of core activity. Summarise key clients and sales achieved to date.
Strategy / Objectives
(Impact of Funding) / Please briefly describe what you wish to undertake with total funding received + the change/expansion in the scope or scale of Company activities which is expected to be achieved.
Do you have a Business Plan prepared? / Yes / No
Where did you hear about the Scheme?
IMPORTANT NOTICE: USE OF PERSONAL INFORMATION

Some of the information in this form is classed as personal data within the meaning of the Data Protection Act.

FSE C.I.C and its subsidiaries (“FSE”) will use this information in its assessment of the proposal and for statistical analysis. For the same purposes, we may share the information with FSE’s advisers, Enterprise M3 Local Enterprise Partnership Ltd (or its successors) and partners of the Enterprise M3 Funding Escalator.

PLEASE SUBMIT COMPLETED PRE-APPLICATIONS TO:

EMAIL:

POST

(if email not available):

Enterprise M3 Funding Escalator
FSE C.I.C.

Riverside House, 4 Meadows Business Park

Station Approach, Blackwater, Camberley, GU17 9AB

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