UnLtd Advantage Enquiry Form UnLtd’s mission is to reach out and unleash the energies of people to transform the world in which they live. We call these people social entrepreneurs. UnLtd Advantage is an investment readiness programme, operated commercially and currently on a success-only fee basis, by UnLtd Ventures. UnLtd Advantage aims to bring high-potential social enterprises to investment readiness to enable them to access the finance they require, and to help social investors identify high-potential opportunities more effectively. We only work with established social enterprises that demonstrate the following characteristics: Proven, scalable social business model Primarily UK beneficiaries Cash flow neutral/positive (preferable) Good management Seeking funding of £250k upwards If you are a social enterprise and think there could be an opportunity for us to work together, please fill out this form and return to firstname.lastname@example.org. Please note that in submitting this form you are verifying that all this information provided is, to the best of your knowledge, accurate. Should you be accepted onto the Advantage programme, verification of all information submitted will take place during the Due Diligence process. At this point, please do not send any further supporting information. 1. CONTACT DETAILS Title First Name Surname Email Address Postcode Telephone 2. ORGANISATION CONTACT DETAILS Organisation Name Website Address Postcode Telephone 3. ABOUT YOUR ORGANISATION Sector Art & Culture ( ) Children/Youth ( ) Disabled ( ) Education ( ) Elderly ( ) Employment ( ) Environment ( ) Ex-Offenders ( ) Health ( ) Mental Health ( ) Refugee/Asylum Seeker ( ) Science ( ) Single Parents ( ) Social ( ) Sport ( ) Technology ( ) Transport ( ) Specific area of involvement Describe your operational activities. (maximum 100 words) Years in Operation 1-2 years ( ) 2-3 years ( ) 3-4 years ( ) > 4 years ( ) Legal Structure Registered charity ( ) Company Ltd by Guarantee ( ) (please mark all that apply Company Ltd by Shares ( ) with an ‘X’) Community Interest Company ( ) Public Ltd Company (PLC) ( ) Combination of above ( ) Not incorporated ( ) What is the social impact of your organisation? (maximum 100 words) Are there primarily UK Yes No beneficiaries? Is your organisation’s business model replicable Yes No or scalable? 4. CURRENT FINANCES Annual Trading Income (a) Annual Grant Income (b) Annual Expenditure (c) Annual Profit /Loss (a+b-c) Do you have a business Yes No plan? 5. YOUR FUNDRAISING REQUIREMENTS How much funding do you £100-£250 ( ) require? £250k-£500k ( ) £500k-£1m ( ) (please mark with an ‘X’) £1m+ ( ) Not sure ( ) When do you require the Within 3 months ( ) funding? Within 6 months ( ) Within 12 months ( ) (please mark with an ‘X’) Flexible ( ) Not sure ( ) What type of funding are Equity Participation ( ) you looking for? Quasi-Equity (revenue ( ) share/royalties) (please mark all that apply Loan ( ) with an ‘X’) Mixture of the above ( ) Flexible ( ) Not sure ( ) Investors you have spoken / secured investment with already. Brief summary of what the investment is to be used for. (maximum 100 words) How did you hear about UnLtd award winner ( ) us? UnLtd website ( ) (please choose all that apply) Event ( ) Flyer ( ) Press coverage ( ) Word of mouth ( ) Referral ( ) By whom?__________________ Have you ever applied for Yes No an UnLtd Award? If so, which? Please note that this information will be used confidentially by UnLtd Advantage. However, in the event that we identify an opportunity to effect an introduction to investor(s), we may share this information, in confidence, with those investors Many thanks for your registration. Please email this completed form to email@example.com and we will get back to you shortly.
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