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Innovation SuperNetwork Grant Expression of Interest Form
Innovation SuperNetwork Grant Scheme
1. Where is your business located?
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Durham
Newcastle
Gateshead
North Tyneside
South Tyneside
Northumberland
Sunderland
2. Is your business registered?
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Yes
No
2a. If 'yes', please provide your company number:
2b. If 'no', please provide an explanation of current status
3. Does your business employ less than 250 staff?
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Yes
No
4. Does your business have an annual turnover of less than £44m (eq 50m euros) or an annual balance sheet of less than £38m (43m euros)
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Yes
No
5. Is your business part of a group? (i.e. does it own more than a quarter of another business or is it more than a quarter owned by another business?)
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Yes
No
7. Has your business received less than £178k (200k euros) public funds support towards innovation consultancy costs over the last 3 years (last 2 full financial year + current financial year)
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Yes
No
8. Please provide your business name
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9. Please provide your name
*
Mr.
Mrs.
Miss
Ms.
Dr.
Prof.
Rev.
Prefix
First
Last
10. Please provide your email address:
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11. Please provide a contact phone number:
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12. Please provide your business registered postcode
*
13. Please provide your business website:
14. Please provide your business sector:
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Manufacturing
Energy
Life Sciences and Health
Creative, Digital, Software and Technology based services
Other
14a. If you selected 'other', please provide your business sector:
15. Where did you hear about the programme?
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Innovation SuperNetwork website
Innovation SuperNetwork event
Third Party
LinkedIn
Twitter
Other
15a. If you selected 'other', please tell us how you heard about the programme:
16. Tell us about your proposed project in no more than 250 words. What is the problem or need and how do you propose to resolve it? Please clearly describe the new product/service/process your business is developing and what the grant and match-funding will be funding to bring it closer to the market.
17. What is the indicative total cost of the project?
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£2,000 - £4,000 (40% max grant)
£4,000 - £7,000 (40% max grant)
£7,000 - £10,000 (40% max grant)
18. Consent
I agree to allow my details to be used by Innovation SuperNetwork to contact me regarding innovation events, programmes and news relevant to the North East of England.
Innovation SuperNetwork will collect and process your personal information following the General Data Protection Regulations (GDPR).
We will only store your personal information for as long as we are contractually required to do so by the funders.
To use your personal information for any other reason, we require your consent. Intermittently we would like to contact you with details of other services, products or events, which we provide. If you consent to us contacting you for this purpose, please tick the box below. You can change your mind at any time by clicking the unsubscribe link in the footer of any emails we send.
I agree to allow my details to be used by Innovation SuperNetwork to contact me regarding innovation events, programmes and news relevant to the North East of England.
Submitting
*
By submitting this expression of interest, I confirm that the information that I have provided in this application form is correct and complete. I understand and accept that if I knowingly withhold information, or provide false or misleading information, this may result in my application not being progressed to the next stage.
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Partners
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