Entrepreneurs Growth Programme form

Please complete the information below, all fields marked with * are mandatory.

Section 1 - Registration information

Name *
Job Title *
Company name *
Address *
Town *
Postcode *
Email *
Website
Office phone number *
Mobile phone number *
Name of HIE account manager (if applicable)

Section 2 - Information for participant photobook

Please describe your business activity

Please describe your role within the business *

Please tell us what your motivation for attending the workshop is *

Please provide outline details of your education and career to date *

Please upload a photograph of you

If you do not wish for your company information to be shared with other participants in the Workshop Photobook, please tick this box

Section 3 - Eligibility information

If your business is based in the Highlands and Islands area you will be eligible for a subsidy of £100 from HIE towards the course fee reducing the rate to £395 per participant. Please note: if you go on to apply for any other public assistance i.e. the SDS Flexible Training Opportunity, you must declare this subsidy from HIE.

Will you be receiving any other public assistance to attend this workshop?

Yes    No

If you answered yes above, please complete section 4 below.
If you answered no above, please proceed to section 5.

Section 4 - Details required if receiving other assistance

In the unlikely event that your assistance levels exceed the State Aid ceiling, HIE may have to offer you a reduced subsidy rate. Please provide details of the additional public assistance you will be receiving (name of grant and amount) to attend this workshop.

Please state the number of full time or full time equivalent employees (FTE) in the business
Please state the business' expected turnover for 2011/2012
Does your business have a parent company with more than 250 employees?	Yes    No
Please state the business' balance sheet total
Please state the cost to the company of the employee attending the workshop
This cost should include their daily wage plus any travel and accommodation costs incurred to attend the workshop.

Section 5 - Accommodation information

Please note: accommodation is not included in the course fee. However, HIE has secured a preferential rate with each course venue for participants. If you would like to take advantage of the preferential rate, please mention the course title when booking.

Please provide details of any special dietary requirements you have below.

Please confirm that you have read the terms and conditions.