Business Impact Challenge – Expression of Interest Form

The purpose of the EOI form is to demonstrate a high level overview of a viable business idea but more importantly show that you are committed to the project and have the right level of buy-in from key stakeholders to ensure its success. The application should be no more than 1500 words. Please send your completed form by 30th November 2016 to Claire Kearney.

Below are the questions that your application should address. Further detail will be requested at the next stage of the application process to any applicants that have been shortlisted.

Name of organisation/s submitting application:

Organisation 1:--------------------------------------------------------------------------------------------------------------------------------------Organisation 2:--------------------------------------------------------------------------------------------------------------------------------------Organisation 3:--------------------------------------------------------------------------------------------------------------------------------------

Name, job title, email and phone number of primary person submitting application

Name:--------------------------------------------------------------------------------------------------------------------------------------Job Title:--------------------------------------------------------------------------------------------------------------------------------------Email:--------------------------------------------------------------------------------------------------------------------------------------Phone:--------------------------------------------------------------------------------------------------------------------------------------

1. Context of the Challenge• What is the social challenge the proposal is trying to address and why is it important to

address?

2. Summarise the proposal• What are your proposed key activities?• Have you engaged with any partners yet, and if so who?

3. Strategic Alignment• How is this investment aligned to your company’s mission and core product, service or

investment strategy?• What core strengths do you bring beyond financial support?

4. Commercials• Indicatively, how much capital are you willing to commit?• Indicatively, what is your £ ask from Big Society Capital?

i) Debtii) Equity

5. Internal Capacity• For each member working on the project please specify:

o Nameo Job Titleo Summary of relevant experienceo % of FTE committed o Length of time committed to project

• What other resources have you committed to the next development stage of this proposal?• Who are the existing supporters of this proposal?• Who else will need to be influenced in order for the project to succeed?• What is your strategy for engaging/influencing the key stakeholders?

6. CommitmentSuccessful EOI applications will proceed to a “Boot Camp” where ideas will be further developed with the support of experienced facilitators. This will involve a nominal cost, and timing will be worked around the applicant’s availability.

Below, please attach the signature of a business manager who can approve this request.

Name:--------------------------------------------------------------------------------------------------------------------------------------Job Title:-------------------------------------------------------------------------------------------------------------------------------------Signature:--------------------------------------------------------------------------------------------------------------------------------------