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5713095-8572500BUSINESS SUPPORT APPLICATION FORMPrincipally Women 3PurposeA programme for female leaders and founders that can significantly support Scotland’s ambitions for digital adoption amongst businesses.Principally Women 3 will target female leaders and founders with a focus on digital adoption to:support female business leaders to gain the right skills and confidence to reach senior positions where they can drive digital adoption in their own businesses andsupport female leaders and founders in businesses whose products/services are enablers to digital adoption in other businesses, to grow, scale and increase the reach of their businesses.Where to get additional helpAny questions please email pw@scotent.co.uk When your application is complete: Print it – Sign it – Scan it – Email it. We can accept a digital signature.Email your signed form as a PDF to: pw@scotent.co.ukSECTION 1: COMPANY INFORMATIONCOMPANY INFORMATIONGUIDANCE NOTESCompany nameThe full name of the applicant business. If the application is successful, this is the legal entity that SE will contract panies House registration numberThe registration number of the applicant business at Companies House.Is the company a Small to Medium Enterprise (SME) or a large enterprise? Please tick one boxDefinitions contained within ‘Terms & Conditions’ at rear of document.An SME?A large enterprise?Company turnoverThe total global turnover of the applicant business at its latest financial year end in pounds sterling.EmployeesTotal global full time equivalent jobs and how many are based in Scotland.Group Structure?(if applicable)If part of a group structure; list any other companies within the group involved in this project or paying associated costs?Trading NamesPlease provide any ‘trading as’ or ‘known as’ name(s) associated with the company which could appear in documentation submitted to SE (e.g. invoices)Applicant contactThe contact details of the person within the applicant business to whom any queries relating to this application may be directed. Any personal data collected here will be used and stored in accordance with SE’s privacy notice. NameJob titleE-mailTelephoneSECTION 2: WHY ARE YOU APPLYING?About you: What’s your story?250 words max What does your company do in 6 words?6 words What does your company do?250 words max Why is digital adoption important for your company?(e.g. How does digital adoption increase your company’s potential to grow? Can your company influence others to be digital adopters?)250 words max The Programme Describe your current plan to support your business to increase its digital adoption and improve digital adoption in others250 words maxDescribe any barriers you have come across when trying to influence digital adoption within your organisation250 words maxWhat are you looking to achieve from the Principally Women programme? How can PW help you to unlock barriers to deliver on your plan and increase its impact? 250 words maxWhat contribution do you believe you can make to the future success of your organisation?250 words maxSECTION 3: FINANCIAL SUPPORTOTHER PUBLIC SUPPORTDo you expect to receive support for this project from public sources other than Scottish Enterprise (including any applications pending)?If yes, please provide further details, including pending applications.Yes No Source of fundingAmount (?)PendingApproved SECTION THREE: DECLARATION BY APPLICANTSPUBLIC SECTOR FUNDINGGUIDANCE NOTESFiscal yearPublic sector source and project titleGrant or LoanAmountDe Minimis Aid amountList all public sector financial support awarded or currently awaiting a decision during the previous two financial years and the current financial year. If you have received no previous public sector support, enter ‘none’ in the first column. If there is no de minimis element to any previous support, enter ‘n/a’ in the final column. Read the notes overleaf on De Minimis Aid.? FORMTEXT ?????? FORMTEXT ?????? FORMTEXT ?????? FORMTEXT ?????? FORMTEXT ?????? FORMTEXT ?????? FORMTEXT ????? ? FORMTEXT ????? ? FORMTEXT ?????? FORMTEXT ?????Total? FORMTEXT ????? ? FORMTEXT ????? DATA PROTECTIONI/we understand that Scottish Enterprise, The Scottish Government, Highlands and Islands Enterprise and other associated bodies such as local delivery organisations, consultants and agents collectively referred to as ‘the Agencies’, will use the information that I/we provide on this application form to assess my/our suitability for support. I/we understand if my/our application is successful, the Agencies will use the information provided in this application form for administration and management purposes, including carrying out appropriate checks, audits and marketing. Your details may also be passed to auditors, the European Commission or its agents for administrative purposes. The Agencies would also like to use this information to help identify services, new products and/or information on seminars that maybe of interest to you or the development of your business.Please confirm if you wish to receive such information: Yes/NoYou have the right to ask for a copy of the information that we hold on you and that is subject to the Data Protection Act 1998, for which we may make a small charge, to correct any inaccuracies in your information held by us. If at any time you wish your details to be removed from our database please contact Scottish Enterprise, Atrium Court, 50 Waterloo St, Glasgow, G2 6HQ in writing or by phone on 0845 607 8787.DECLARATION BY APPLICANTSGUIDANCE NOTESI confirm that:ConfirmCompany statement:I certify that the information given on this form regarding my company and project is accurate to the best of my knowledge. A director of the company must complete this declaration. Then print, sign, scan and email the completed application to pw@scotent.co.ukIf you are a sole trader, you can still apply for this programme. Please sign and include the words “(Sole trader)” in brackets.Name of DirectorSignatureDateTERMS AND CONDITIONSDe Minimis AidIf you have had public sector support, you should have been notified in writing of any de minimis element when the aid was awarded. If it is applicable, prior to granting de minimis aid, Scottish Enterprise must obtain a declaration from the firm concerned, in written or electronic form, about any other de minimis aid.Under EC Commission Regulation No 1998/2006 of 15 December 2006 on the application of Articles 87 and 88 of the Treaty to de minimis aid (“the Regulation”), this Grant is de minimis aid. There is a ceiling of €200,000 for all de minimis aid provided to any one recipient over a 3 year period. The Grant will be relevant if the Recipient wishes to apply, or has applied, for any other de minimis aid. For the purposes of the Regulation, the Recipient must retain details of the Grant for 3 years from the date on which the Recipient receives the last instalment of the Grant and produce it on any request by the UK or European public authorities.Definition of a Small or Medium Enterprise (SME)An SME is an enterprise which employs fewer than 250 persons and which has an annual turnover not exceeding 50 million euro, and/or an annual balance sheet total not exceeding 43 million euro and is independent. An independent enterprise: no more than 25% of the capital or voting rights are owned by one or more enterprises which fall outside the SME definition.Full Time Equivalent (FTE)Annual salary of individuals claimed – SE will apply standard formula for calculating the grant (excludes employees NI, car lease, bonuses, other benefits etc). ................
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