Form

Yorkshire and the Humber
Leadership and Management Advisory Service

THIS FORM IS FOR THE YORKSHIRE & HUMBERSIDE REGION ONLY
Online Application Form

Please complete all the questions on the following pages. This application should take no longer than 5 minutes
If you wish to navigate to another page, please use the BACK and NEXT buttons.
Do not use your browsers navigation buttons.

Questions which are starred (*) are compulsary.

Eligibility Criteria for Funding:

Funding is only available for private sector businesses or social enterprises that:-

· Have fewer than 250 full time equivalent employees (or fewer than 250 employees within the group if part of a group of companies), and

· Have at least one full time equivalent employee in addition to the beneficiary, and display the potential for high or fast growth defined as one of the following (please select) :
The Business is*

An established business (trading for 12 months or more) with the potential to increase turnover by 60% within three years. A new business (trading for less than 12 months) with the potential to achieve a turnover of £500,000 within three years of starting trading An established Social Enterprise* with the potential to increase turnover or employment by 30% within three years
If you are a new business, or have recently changed address, you are likely to be contacted by EDS/Blue Sheep calling on behalf of the Skills Funding Agency to verify your contact and address details. Failure to provide this information may result in delays or non-payment of the grant.

Page 1 of 5
PART 1: COMPANY DETAILS
Company / Organisation Name*

Address*

Street Address
Street Address Line 2
City	County
Postcode	Country

Are you part of a group of companies?*

No Yes
Legal Status*
Sector*
Nature of Business
Number of Employees (PAYE)*
Please include Full-Time and Part-Time employees
Annual Turnover Last Year £*
If this is your first year of trading, please enter "0" in the box
Name of Person seeking L&M Support**
Position*
Contact Email*
Contact Telephone Number*
- Area Code Phone Number
Contact Mobile Number
- Area Code Phone Number
What type of training/ development are you looking to spend the grant on (if known)?

Page 2 of 5
Part 2 – High/Fast Growth Pre-assessment

To confirm your eligibility a more detailed assessment will be carried out by one of our Advisers where evidence to support your statements below will be required. Please answer “Yes” or “No” to the following 12 questions:
Do you have a Business Plan in place?*
Do you have a positive cash-flow?*
Do you plan to grow by reaching new markets?*

Page 3 of 5
Do you plan to grow by developing new products/services?*
Does your Business Plan show profit growth?*
Does your Business Plan show an increase in staff numbers?*

Page 4 of 5
Do you have potential new contracts / orders?*
Do you have stability of existing contracts / orders?*
Do you operate internationally or plan to operate internationally?*

Page 5 of 5
Have you (or your business partner) set up and run a successful business previously?*
Are you a member of a business network e.g. Chamber, IoD, CBI?*
Do you have a business qualification e.g. MBA, management NVQ?*
Any other information you would like to give us?

Submit your application
If you scored 9 or more (8 or more for Social Enterprises) of these responses as "Yes", it is likely that you can be accepted for support once these responses are verified by our Adviser. An Adviser will contact you within 5 working days of receipt of this form.

If you scored 7 or 8 (6 or 7 for Social Enterprises) of these responses as a "Yes", we shall obtain an Experian Business Delphi score for your organisation (at no expense to you). If this shows an improving score it is likely that you can be accepted for support once these responses are verified by our Adviser. Please allow 10 working days for an Adviser to contact you.

If you scored 6 or less (5 or less for Social Enterprises) you cannot be accepted for support at this time. Please only submit this form if you would like to discuss other development opportunities with our team.
Should be Empty:

Yorkshire and the Humber

Leadership and Management Advisory Service

Online Application Form

PART 1: COMPANY DETAILS

Part 2 – High/Fast Growth Pre-assessment

Submit your application