LeadUS Mentoring Program 2015-16

Start-Up Visa

Expression of Interest Form
The information provided in this document is a mechanism to assist with identifying your eligibility to apply for a Start-Up visa and to identify the development and commercial potential of your business idea and any associated intellectual property. You will often see intellectual property abbreviated in documents to IP.

Please complete this document as fully as possible. Answers for some parts of the form are mandatory, if you are unable to answer any of the mandatory questions this will prevent you from proceeding any further. For other questions you are unable to answer please insert N/A.

Following submission and the application closure deadline, the startup visa business support team will review your application and if successful you will be invited to a business development session. For more information on the full process please refer to the Start-Up Visa website here: https://www.lboro.ac.uk/students/len/visa/

Please note we will not review the expression of interests before the deadline.

All information is held in accordance with the GDPR, and will not be used for non-University activities. Your details will never knowingly be passed onto anyone without first obtaining your permission.

PLEASE NOTE: There is no 'save' button. The form will have to be completed in one sitting.

Any questions or technical issues please contact startupvisa@lboro.ac.uk

Visa Information
1. Have you previously set up a business in the UK prior to this expression of interest?*

YesNo
If yes please give details:
2. Are your current studies fully funded by a government paying all tuition fees and living expenses?

Yes - your government sponsor will need to consent to any application for a Satrt-Up Visa or you will have to apply at least 12 months after funding has finishedNo
3. If your business plans are approved will you be able to show you have kept the required level of funds throughout 90 days prior to making any Start-Up visa application? (The required level of funds is £945 if applying in the UK, £1,890 is required if applying outside the UK)*

YesNo - The University will not be able to provide an endorsement letter for visa purposes

Contact Details
Full Name*

First NameMiddle NameLast Name
E-mail*
Mobile Number *
Student ID Number*
Telephone Number

Area CodePhone Number
Nationality*
When does your current visa expire?*
Term time address*

Street Address

Street Address Line 2

CityCounty

Post Code
Home/Family Address (compulsory if different to the term time address)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

About Your Studies
Currently undertaking (select one only):

Undergraduate Degree CourseMastersPost Graduate ResearchIf you have finished please complete boxes further down for Graduates
Campus Affiliation - Which campus did/are you study(ing) at?:

Loughborough University - East MidlandsLoughborough University London - London
What year of study are you currently in?*
What School/Department are/did you studying in?*
Key School/Department Contact:*
(name of person(s) who have had the most input into this project such as academic staff, tutors etc, if any)
Are you a Graduate?*

YesNo
If you are a Graduate - what year did you graduate?

Who is involved or has helped develop the Business Idea?
Please provide the names of all people/partners - including other graduates, external partners, academic members of staff or students that may have assisted in your business idea to date.

Please note if any partners in the business also require a Start-Up Visa they will need to complete this form in full.
Name of 1st Additional people/partner:

Please note if any partners in the business also require a Start-Up Visa they will need to complete this form in full.

This only applies to students or graduates from Loughborough University, no students or graduates from other institutions will be accepted.
Title
Full Name
Job Title
Address
Email
Telephone/Mobile/Ext no:
Did they help develop the idea?

YesNo
Do they need to apply for a Start-Up Visa?

YesNo
If you have selected yes to the above option then please note:

Loughborough University only endorses students/graduates who have completed a Loughborough University accredited degree.

Assistance with Business Idea - Name of 2nd Additional people/partner:

Please note if any partners in the business also require a Start-Up Visa they will need to complete this form in full.

This only applies to students or graduates from Loughborough University, no students or graduates from other institutions will be accepted.
Title
Full Name
Job Title
Address
Email
Telephone/Mobile/Ext no:
Did they help develop the idea?

YesNo
Do they need to apply for a Start-Up Visa?

YesNo

Assistance with Business Idea - Name of 3rd Additional people/partner:

Please note if any partners in the business also require a Start-Up Visa they will need to complete this form in full.

This only applies to students or graduates from Loughborough University, no students or graduates from other institutions will be accepted.
Title
Full Name
Job Title
Address
Email
Telephone/Mobile/Ext no:
Did they help develop the idea?

YesNo
Do they need to apply for a start-Up Visa?

YesNo

The Business Idea
Business Name
Please provide a description of the business idea.
What does your business do and who is it for? Is it a new process, a service, a device or product? A new use for an improvement on an existing process, service, device or product? Please put this in layman's terms and include background/intro to make it easy to understand where this idea has come from and why. Please do not use any jargon or unnecessary information in this description.
Please evidence why your business needs to be in the UK to succeed.
To be considered for the Start-Up Visa your business needs to be 'Innovative, Viable and Scalable, please provide evidence on how you reach this criteria.
Have you received any funding for your business idea? If so please provide details of where this has come from, including any dates.
This includes but is not limited to Princes Trust, any UK Charities, Sit Thomas White Charity, Competitions etc.

Development
At what stage of development is the business idea?
With the business idea at its current stage, how soon will you start trading?
Please give details about the steps needed to commence trading.
What is the Unique Selling Point of your business.
What makes your business different from others in the same sector?

The Market
Please describe the market and competition for your business idea.
Who is your target customer? What is the current market competition?
Are there any recognised technical, statutory, or industrial standards for your business idea? If so, how easy will it be to meet these standards?

Disclosure/Confidentiality
Confidentiality - Is your business idea confidential? Have you spoken about your business idea to anyone outside the University/published it/posted it online/presented in a conference or seminar, told friends or family?
Have Confidentiality Agreements already been signed?
You may be asked to provide copies of these.

IP and Ownership
Is there any IP involved in the business idea? If so please provide full details:
Does the business idea require access to any other IPR, especially if owned by a third party?
Is it linked to staff/university research?

Searches/Due Diligence
Have you carried out your own due diligence, ie patent searches, registered design and trademark searches?
Please list what searches have been carried out in order to determine whether this idea is novel or has been disclosed previously? You may be asked to provide further details.

Declaration
I confirm that the information presented in this document is accurate and to the best of my knowledge is my original work. Loughborough University shall not be held liable for any views held or expressed in connection with this document.

I understand that the Start-Up Visa Business Support team at Loughborough University will hold this data on file.
Name*
Main Contact*
Signature*
Please note: As this document is being completed electronically, in the absence of a signature type your name in the box above which constitutes your personal certification that all of the details submitted are your own and are correct.
Date*

Should be Empty:

Start-Up Visa

Visa Information

Contact Details

About Your Studies

Who is involved or has helped develop the Business Idea?

Assistance with Business Idea - Name of 2nd Additional people/partner:

Assistance with Business Idea - Name of 3rd Additional people/partner:

The Business Idea

Development

The Market

Disclosure/Confidentiality

IP and Ownership

Searches/Due Diligence

Declaration