TEST PAGE

All questions are required to be completed in order for your Back to Business application to be fully reviewed. If a question is not relevant please write N/A and move on to the next question.

Qualifying questions:

Are you a Small or Medium Size Business?

Are you based in one of the following boroughs? Croydon, Hammersmith & Fulham or Southwark?

Do you receive at least 50% of your income from trading activity?

Section 1 - About your business

Applicant business name

Your full name

Your role in the organisation

Business address

Which borough are you located in?

Please note that this fund is only available to businesses located in Croydon, Hammersmith & Fulham and Southwark.

Which of the following sectors do you belong in?

Are you a ratepayer?

If you answered yes to are you a ratepayer, what is your account number?

Please enter your account number if you are a ratepayer. If you do not have an account number please write N/A and move on to the next question.

If you answered no to are you a ratepayer, please provide evidence of the address of your premises.

This can include evidence of lease, business bank account statement from the last 3 months displaying your premise address. You do not need to answer this question if you have provided an account number. (Please note the file may take a while to upload, please be patient and do not close the window).
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Please select your trading status

Do you have a company registration number?

If you answered yes to do you have a company registration number, what is your company registration number?

Please enter your company registration number. If you can not provide your company registration number, please write N/A and move on to the next question.

If you answered no to do you have a company registration number, please provide your unique taxpayer reference below.

Please enter your unique taxpayer reference below. If you have already provided your company registration number please write N/A and move on to the next question.

As well as your unique taxpayer reference, can you provide evidence of public liability and employer’s liability insurance and a statement of the organisation’s turnover, profit & loss/income & expenditure and cash flow position for the most recent full year of trading/operations where this information is not available in audited form.

If you can provide these documents please select yes and upload them to the relevant file upload functions below. If you can't provide these documents, please select no and move on to the next question. If you have provided your company registration number, you do not need to provide any additional documentation.

Public liability insurance

Please note the file may take a while to upload, please be patient and do not close the window.
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Employer's liability insurance

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Statement of your organisation's turnover, profit and loss/ income and expenditure and cashflow

Please note the file may take a while to upload, please be patient and do not close the window.
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What year was your business established?

Website address

Does the business have its own bank account?

What was your company turnover last year?

How long has your business been trading?

How many people, including self-employed/freelancers, do you employ?

Which challenges is your business facing as a result of COVID-19? Choose all that apply.

Please tell us what revenue decline you’re experiencing as a result of the COVID-19 crisis?

Please provide supporting evidence to demonstrate the adverse impact Covid-19 has had on your business. For example, audited accounts (or, in the absence of accounts, bank statements) over a comparable trading period (e.g. pre and post-Covid) showing a decline in revenue.

Please note the file may take a while to upload, please be patient and do not close the window.
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Evidence upload 2

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Have you applied for or received government funding support? If so, please outline which ones here.

Are you currently in receipt of any other match fund schemes offered through Crowdfunder?

If yes, which ones and how much are you receiving?

If you answered no and have not received any match fund schemes through Crowdfunder, please write N/A and move on to the next question.

Tell us why you need this funding.

Please tell us a bit more about your current circumstances and any cashflow problems you’re experiencing

Section 2 - Use of funds

This funding is provided on the basis that eligible businesses use the funding to increase their resilience, digitise their business, upskill their employees, adapt to trading through Covid-19 or innovate. For example, this could include: Changes to operations, consumer engagement or business model in order to continue to trade viably or adaptations needed to ensure that your product meets more stringent hygiene guidelines or improve consumer confidence or investment in technology solutions such as e-commerce, accounting software, customer relationship management (CRM), cloud-based computing and building or upgrading your website.

Find out more about the eligibility criteria here

Clearly explain how this funding will increase business resilience by supporting you to adapt or innovate in response to Covid-19.

Please provide as much detail as you can. You may attach a business plan or digital transformation plan outlining how you propose to implement these changes within your business. You can use this template here.

Please upload your business or digital transformation plan here (optional)

Please note the file may take a while to upload, please be patient and do not close the window.
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Please provide a budgeted allocation of funding or a budget detailing which activities within your organisation will be funded.

The budget must contain details of proposed expenditure e.g. IT equipment purchase, production costs, staffing costs (can only be covered in relation to project implementation). Please note we are only looking for a budget for the match funding amount you are seeking, not your entire crowdfunding campaign target. (Please note the file may take a while to upload, please be patient and do not close the window).
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Do you have sufficient staff time, capacity and expertise to undertake the requirements of this funding, including all expenditure, within 3 months of the completion of your crowdfunding campaign?

If you answered no, what mitigating circumstances are you putting in place?

If you answered yes to this question please write N/A and move on to the next question

Diversity questionnaire

For monitoring purposes, we would like to understand a bit more about your business. Please complete our fully anonymous diversity questionnaire. The form will open in a new window. Access the form here.
To apply for the Back to Business fund you are required to complete the Diversity questionnaire. Please note this form is anonymous and will not affect your application.