Expression of Interest Form

WIN MORE BUSINESS PROCUREMENT PROGRAMME

Expression of Interest Form
1. APPLICANT INFORMATION
Name *

First Name Last Name
Company *
Business Address *
Postcode *
Mobile No
Telephone No
Email *
example@example.com
Website
2. TRADING INFORMATION
Are You Currently Trading? *

Yes No
How Long Is Your Business Established (Years/Months)
3. NUMBER OF PEOPLE IN EMPLOYMENT
(Must have under 50 employees to be eligible to apply)
Full Time Employees
Part Time Employees
4. EXISTING TENDER OPPORTUNITIES
Do you have any upcoming tender opportunities *

Yes No
If Yes please provide detail…
5. PLEASE PROVIDE A SHORT DESCRIPTION OF YOUR PRODUCT OR SERVICE
Sector
Product/Service Summary
Existing/Target Customers
6. DE MINIMIS & INVEST NI SUPPORT
Are you an Invest NI client company? *

Yes No
If so please provide name of Invest NI Client Manager.
Are you currently in receipt of any support or financial assistance from Invest NI? *

Yes No
Details
Has the company or any company within the Group (if applicable) received any form of public support or grant that was classed as de minimis in the last 3 years? The maximum amount of de minimis aid that an undertaking can receive within a 3- year fiscal period is €200,000 *

Yes No
Details
7. OTHER
(Please tick as many as are relevant)
Where did you learn about the ‘Win More Business Procurement’ Programme?

Email Phone Call Newspaper Website Facebook Twitter Linkedin Poster/Flyer Council Officer Word of mouth Other
Should be Empty:

WIN MORE BUSINESS PROCUREMENT PROGRAMME