EMIN Enterprise solutions

Enterprise Inc Application Form
Please complete this application form to be considered for funding from the Enterprise Inc Project.

First Name: Surname:

Address: Postcode:

Date of birth:

Phone number:

Email address:

Confirm email:

Gender: Male Female

Degree year:

University name:

Course:

Date graduated: (if applicable)

How did you hear about the programme:

Ethnic group:

Do you consider yourself to have a disability? Yes No

Please write a brief description below about your business idea and what stage of development you are at:

Will the business be set up on your own or jointly with others? If with others please state how many and their names.

Please detail when you expect to start trading with the business (i.e. 1-3months, 3-6 months, 6months and over) and what support you need to achieve this.

Declaration

I acknowledge that in some circumstances an award may be made subject my acceptance of special conditions imposed and I further acknowledge that payment may be made subject to my satisfactory completion of milestones and agree to comply with any conditions imposed.

I understand that the method of payment will be at the discretion of EMIN and any liability for payment will end at the completion of my placement period.

I accept that EMIN and its University partners guarantee that this information will not be shared with any third parties, or be used for any other purpose, except for the legitimate audit of this project.

I confirm that I am legally entitled to set up a trading enterprise in the UK and that there are no restrictions placed upon me in this regard (i.e. nationality/visa/court restrictions etc)

I confirm that I have not already started trading with my business idea and understand that if I start a business before a place is offered to me I will be ineligible for funding.

I declare that the details given on this form are true and to the best of my knowledge.

This project is part funded by:

Part funding by European Union, Higher Education Funding Council for England and Supported by East Midlands Development Agency.

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