Stelios Award for Disabled Entrepreneurs in the UK 2015

Stelios Award for Disabled Entrepreneurs in the UK 2015

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Stelios Award for Disabled Entrepreneurs in the UK 2015

Application Form

Please apply if you meet the following eligibility criteria:

  • You have a recognised disability or long term health condition
  • You have at least 25% management stake in your company
  • Your business has a turnover in excess of £10,000
  • You have a UK registered business
  • Your business has been trading for between 2 and 5 years

* Mandatory fields

Please complete form electronically

*Do you give consent to Leonard Cheshire Disability to process the personal and sensitive information that you have provided on this form and in attachments, and share it with the Stelios Philanthropic Foundation and Stelios Award judges?

Yes No

If you have answered ‘No’ to the above question, unfortunately we will not be able to include your application in the running for the Stelios Award for Disabled Entrepreneurs in the UK 2015.

Contact Details

*First Name*Last Name

* Date of Birth

/ /

* Company Name

* Company Address

Address line 2

* City* Postcode

* Email Address Website Address

* Telephone Number Mobile Number

Company Details

* Business Sector

* Nature of Business

* Main Product/Service

* Number of Employees

* Legal Status of Company

* Date Business Registered* Date Trading Began

(No earlier than 01/06/10, no later than 30/09/13)

/ / / /

* What percentage management stake do you have in the business?

Figures

Your business’s financial year 2012/2013 / Your business’s financial year 2013/2014 / Your business’s financial year 2014/2015 / Projection 2015/2016
* Turnover (£)
* Net Profit (£)

Please attach audited accounts for 2013/14 and 2014/15 with your application (or profit/loss if your accounts don’t get audited)

*Please describe your disability

*As a disabled entrepreneur, what are some of the challenges you have faced and how have you overcome them? (200 words allowed)

*Please provide a brief description of your business, the products or services it supplies, its customers and the markets in which you operate, and how you run the business (200 words allowed)

*Please outline the overall trend in your sales turnover and profit development, together with a brief description of key strategies that have led to these changes

Consider the following: marketing, workforce development, customer recruitment and retention, environmental impact, financial planning and control, supplier relationships and management, operations, IT, and innovations (500 words allowed)

*What are your objectives for the business over the next 3 years and how would winning £50k help you achieve them? (200 words allowed)

If you have any other attachments to support your application, please include them

(max. 2 MB)

*Please tell us how you found out about this year's Award

Word of Mouth ______

Leaflet ______

Search Engine ______

Website ______

Article ______

Other ______

* Is your business currently involved in any court cases?

Yes No

* Please confirm that all of the information in this application form is true and accurate

Yes No

* Please confirm that you have attached your audited accounts (or profit/loss) for 2013/14 and 2014/15

Yes No

Thank you for completing the application form.

Please submit your application, along with a copy of your audited accounts,before the deadline of 5pm on Friday 18th September 2015.

If you are downloading the application form, please complete it electronically and email it, along with your audited accountsto r alternativelysend them in the post to:

Enterprise & Innovation

Leonard Cheshire Disability

66 South Lambeth Road

London SW8 1RL

We will contact you in October to let you know if your application has been successful.Good luck!