First name

Last name

And, your email address?

And, the best number to directly contact you on?

These next few questions covers monitoring and evaluation for our partners. All questions are optional and we appreciate any cooperation.

What is your gender?

What is your ethnic group?

Which of the following best describes your sexual orientation?

Do you have any physical or mental health conditions or illnesses lasting or expected to last 12 months or more?

Do any of your conditions or illnesses reduce your ability to carry out day-to-day activities?

Now, let's get a bit more information about your company...

What's your company called?

Which of these best describes the sector you work in?

Where is {companyName} based? Please include full address including postcode.

It would be great to understand more about what you do, please provide your business bio here.

Please provide your business logo here

How many full-time equivalent members of staff do you have at the moment? 

Please count part-time members of staff in this total

What's your annual turnover from your latest complete financial year?

Please pick which year your annual turnover figures relate to

This project involves a Minimum Financial Assistance (MFA) subsidy under the Subsidy Control Act (2022). Minimal Financial Assistance (MFA) allows public authorities to award low value subsidies without needing to comply with the majority of the subsidy control requirements.

MFA has a threshold for the amount of public funding/publicly funded support a business is entitled to receive. The threshold is £315,000 over an applicable 3 financial year period and the Act defines a financial year as a period of 12 months ending on 31 March. The applicable 3-year period is the elapsed part of the current financial year (i.e. from 1 April), and the previous two financial years immediately preceding the current financial year.

I declare that over a rolling three-year period, {companyName} has previously received less than £315,000 Minimum Financial Assistance (Subsidy Control) and I confirm that I am authorised to sign on behalf of the company / organisation named in this form. I confirm that I accept that if the company / organisation named in this form fails to meet the eligibility requirements, the company / organisation may become liable to repay the full price that would otherwise be payable in respect of the services received.  

Please provide the total Minimum Financial Assistance (Subsidy Control) {companyName} has received over the last three years (excluding funding related to this application).

The State Aid value of this program is £3,700. A reasonable estimate of the likely maximum value of the MFA that your enterprise will receive in the project should be shared with you ahead of the program. You will receive a letter confirming this for your records after the final session, with the final total of state aid being £2,950, considering that you have paid £750.

Now, let's get a bit more information about your Emerging Leader...

Please state the full name of the team member you'd like to put forward for the Emerging Leaders programme

So we can contact them to complete the application, please provide their email address…

And their number…

Are you happy for us to contact them straight away?

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