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Company Application Form
Please complete all fields of the form below. Please note that this information may be shared with Invest NI for information only
Company Application Form
Company Name
Company Address (including postcode)
Company Telephone
Company Contact Name
Company Contact Email
Company Website
Date of Establishment
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Financials (please state company year-end date):
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Sales last year (£ 000s)
Sales Forecast current year (£ 000s)
Sales Next year (£ 000s)
EBIT Last year (£ 000s)
EBIT Forecast current year (£ 000s)
EBIT Next year (£ 000s)
Net Assets (£ 000s)
Net Debt / Cash (delete as appropriate) (£ 000s)
Employee numbers
Target completion date for the investment
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Month
January
February
March
April
May
June
July
August
September
October
November
December
Year
1923
1924
1925
1926
1927
1928
1929
1930
1931
1932
1933
1934
1935
1936
1937
1938
1939
1940
1941
1942
1943
1944
1945
1946
1947
1948
1949
1950
1951
1952
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1954
1955
1956
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1958
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1961
1962
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1967
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1969
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1971
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1977
1978
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
2020
2021
2022
2023
2024
2025
2026
2027
2028
2029
2030
2031
2032
2033
2034
2035
2036
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2040
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2042
2043
Industry Sector
Advertising
Agriculture
Arts
Automotive
Bioscience
Business Services
Construction
Distribution
Education
Electronics
Engineering
EnvironmentalEnergy
Financial Services
FMCG
Food Processing
Hospitality
Information Technology
Internet
Leisure
Manufacturing
Materials
Medical
New Media
Packaging
Pharmaceuticals
Printing
Property
Publishing
Retail
Software
Telecommunications
Textiles
Type of Investment Opportunity
Seed: Low level financing needed to prove a new idea
Start-up: Early stage firms that need funding for expenses associated with marketing and product dev
First Round Growth Series A round: Early sales and manufacturing funds
Second-Round Working capital: Companies that are selling product, but not yet profitable
Expansion : Expansion money for an already profitable company
Pre IPO or Exit : normally intended to finance the "going public" process
MBO:
Recapitalisation and/or refinancing:
Other
Type of Investment Opportunity - Other
Brief description of the business activity and specific use of funds being raised
Total amount and sources of funding being sought including equity, grant and other finance
Total amount and sources of private investment
Lead private investor(s) name(s)
Lead private investor(s) telephone(s)
Lead private investor(s) email(s)
The Company has tried to raise its total equity funding requirement from private sources and been unable to do so, and so has a funding gap
yes
no
If yes please outline details of the Companies efforts to source private investment.
Please attach documents supporting your application to the fund including as a minimum a business plan, financial projections and most recent management accounts. You may also attach copy of any further documents that you think are appropriate including for example fund raising or technical presentations, term sheet or offer letter, share cap table, external dd reports or market analyst reports; and any other supporting documents already provided to your private investors.
Business Plan
Financial Projections
Management Accounts (most recent available)
Any other relevant documents (single zip file please)
Submit