Open North Foundation

    Company Details

    Primary Contact

    Business Size

    Are you a small or medium size enterprise?

    YesNo

    If Yes please provide details of:

    Is the company part of a group?
    YesNo
    Do you or any other business partner, member, principal investor or director of this business have an interest or control over any other business?
    YesNo
    If yes please list these below, with a summary of relationship and % holdings:

    Impact of COVID-19

    Grant Amount
    (You can tick more than one box, please specify what the grant will be spent on for each amount ticked)

    Up to £1,000

    £1,000 to £2,000

    £2,000 to £3,000

    £3,000 to £4,000

    £4,000 to £5,000

    Job Creation / Job Retention

    Details of other financial support received


    AppliedReceived
    If yes, what was the value? eg £3000


    AppliedReceived
    If yes, what was the value? eg £3000


    AppliedReceived
    If yes, what was the value? eg £3000


    AppliedReceived
    If yes, what was the value? eg £3000


    AppliedReceived
    If yes, what was the value? eg £3000


    AppliedReceived
    If yes, what was the value? eg £3000


    AppliedReceived

    Bank/Chartered Accountant Reference

    Additional Documentation

    In addition to the above form to allow us to make the grant funding we require the following documentation, could this information be emailed to : enquiries@opennorthfoundation.co.uk

    - Last full annual accounts
    - Latest management accounts
    - Copy of latest budgets/cash flows (if available)

    If you do not prepare forecasts or budgets please provide details of how you expect the company's results to change over the next two financial year ends, in line with business plan and provide some commentary on how you expect to achieve these results (maximum 250 words):

    Declaration and understanding



    YesNo



    YesNo



    YesNo

    Consent

    I am content for information supplied here to be stored electronically and shared in confidence with other public sector bodies, who may be involved in considering the case. I understand that if I give information that is incorrect or incomplete, grant may be withheld or reclaimed and action taken against me. I declare that the information I have given on this form is correct and complete. I understand that any grant offer, grant receipt and projected use of the grant may be publicised by means of a press release giving details of the project and the grant amount.
    Yes

    Open North Foundation

    Open North Foundation is not a registered charity and is a private company limited by guarantee (Company number 10621351). The objectives of the foundation can be found on our website: opennorthfoundation.co.uk.