• First Name *
• Last Name *
• Organisation name *
• Email *
• Website *
• What county are you based in? *
  Please select one of the options Bedfordshire Berkshire Bristol Buckinghamshire Cambridgeshire Cheshire City of London Cornwall Cumbria Derbyshire Devon Dorset Durham Essex Gloucestershire Hampshire Herefordshire Hertfordshire Isle of Wight Kent Lancashire Leicestershire Lincolnshire Greater Manchester Merseyside Norfolk Northamptonshire Northumberland Nottinghamshire Oxfordshire Rutland West Midlands Shropshire Somerset Staffordshire Suffolk Sussex Surrey Tyne and Wear Warwickshire Wiltshire Worcestershire Yorkshire

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You will need to commit time and energy to this programme (approx. 3 day per month for 5 months).

• Please describe how will you organise your team to ensure you can meet these requirements *

If shortlisted, you will be required to attend an online interview in either April or May. If accepted you will be required to attend the kick-off event on 3 June and celebration event in person on 30 October. Are you able to attend these events?

• Availability for key dates
  Yes No
• How long have you been trading as a social enterprise?
  - Select a Value - Less than a year 1 to 3 years 4 to 9 years Over 10 years
• Annual turnover
• Company legal structure
  Company Limited by Shares (CLS) Company Limited by Guarantee (CLG) Community Interest Company (CIC) Community Benefit Society Charity Sole Trader Partnership Not registered

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Does your business meet the following programme criteria:

1. Over 50% of income through trade

2. Over 50% of profit reinvested into social/environmental purpose

3. Social/environmental purpose clearly defined in governance documents

4. Majority controlled in the interest of the social/environmental mission

• Do you meet the programme criteria?
  - Select a Value - Yes No

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• Please describe your business model, including the products/services that you offer *
• Please describe the social and /or environmental purpose of your organisation and the impact you have achieved to date *
• What are your goals for organisational growth? Please describe the scale (geographic, market reach and turnover) you would like to achieve in 1 year, 3 years, 5 years?
• Do you employ or secure employment for people who would otherwise face barriers to employment?
  Do you employ or secure employment for people who would otherwise face barriers to employment? Yes No
• Are you keen to explore low-carbon heating skills development and market opportunities, and how do you foresee this helping your organisation to grow?
• How did you hear about ASSETS?
  - Select a Value - Local council Impact Hub London Wayfinder Social media Email Word of mouth Flyer
• Do you consent to the processing of your personal data contained in the application form, and sharing this data with our recruitment partner, Wates?
  Yes No

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