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Little British Battler Day Company Registration November 2016

LBB logoThank you for your interest in participating in the TechMarketView Little British Battler Day, presented in association with MXC Capital.
The event will be held in London on Tuesday 15th November 2016.
Please submit this pre-qualification form by Friday 7th October.
We aim to notify successful applicants by Friday 28th October.
If you have any further queries please contact lbb@techmarketview.com.
 
COMPANY INFORMATION

Company name *
(Company name)
 

Company number *
(Company number as registered at Companies House)
 

Company address *
(Address of company headquarters)
 

Company phone
(Switchboard number)
 

Website *
(Company website)
 

Twitter handle
(Company Twitter handle)
 

LinkedIn page
(Company LinkedIn page)
 

Year founded *
(Year company founded )
 

Company description *
(Brief description of your company's products and/or services)
 

Number of employees *
(Please select from the drop-down list the number of full-time equivalent employees in your company)
 

Primary revenue source *
(Please select from the drop-down list which area your company derives the largest proportion of its revenues from)
 

Other primary revenue source
(If you specified 'Other' above, please briefly explain)
 

Key executives *
(Please list the names and roles of the key executives in your company)
 

Company shareholders *
(Please list individuals or institutions who have more than a 5% shareholding in the company and the approximate percentage.)
 

COMPANY OPERATIONS

Company geographies *
(Please tick all geographies in which your company currently has active operations such as sales offices, development labs, support centres, partners, etc)
 
















Client geographies *
(Please tick all geographies from which you derive more than 10% of your total revenues.)
 
















Non-UK turnover *
(Please select from the drop-down list the approximate percentage of your turnover that derives from clients outside of the UK?)
 

Client vertical market sectors *
(Please tick all those vertical market sectors from which you generate more than 10% of your company's revenues.)
 















Other
(Please specify which other market sector(s) are responsible for at least 10% of your company's revenues if not in the list above.)
 

Client concentration *
(Please select from the drop-down list the approximate percentage of your company's revenues that derive from your Top Five clients)
 

Notable clients
(Who are your Top Five clients? Please note any that are confidential.)
 

Strategic partners
(Please list any partner organisations that are directly or indirectly responsible for more than 10% of your revenues)
 

COMPANY FINANCIALS

Company revenues *
(Please indicate from the drop-down list your company's revenues in its most recent financial year.)
 

Revenue growth *
(Please select from the drop-down list the approximate change in your company's revenues in the last twelve months.)
 

Recurring revenues *
(Please select from the drop-down list the approximate percentage of your revenues you consider to be 'recurring', i.e. regular, periodic, contracted?)
 

Proprietary IP *
(Please select from the drop-down list the approximate percentage of your revenues that derive directly from your company's proprietary intellectual capital?)
 

Company EBITDA *
(Please select from the drop-down list your company's EBITDA in its most recent financial year)
 

MARKET POSITIONING

Key themes *
(Please tick up to THREE key themes that your company plays to. If OTHER, please identify in the box below.)
 









Other theme(s)
 

Theme proposition *
(Please briefly explain how your product/service plays to the theme(s) you indicated above.)
 

Market disruption *
(Please briefly explain why you believe your products and/or services are disrupting the market and its traditional players.)
 

Obstacles to growth *
(What would be the main obstacles to doubling your revenues in the next 12-24 months were you to aim to do so (please select up to THREE)? Feel free to elaborate in the box below.)
 














Explanation about key obstacles
(Please fee free to elaborate on your key obstacles to growth - especially if you selected OTHER)
 

Reason to be an LBB *
(Please briefly explain why you believe your company should be selected to participate in the LBB day?)
 

BREXIT

BREXIT vote impact *
(Please select one option from the dropdown list that best describes the impact on your business of the UK's decision to exit the EU. This is the impact of the VOTE, not the exit itself.)
 

Explanation on Brexit vote impact
(Please explain here about the impact of the Brexit vote if not adequately covered above)
 

Expected impact of BREXIT *
(Please select from the dropdown list the most likely impact you expect on your business once the UK has exited the EU.)
 

Explanation of Brexit impact
(Please explain further about the impact you expect on your business after the UK exits the EU if not adequately covered above)
 

RESPONDENT INFORMATION

Forename *
 

Surname *
 

Position *
(Role within company)
 

Contact phone *
(Your contact phone number)
 

Email *
 

Source of knowledge *
(Where did you hear about the TechMarketView LBB Programme?)
 

Other
 

PLEASE PRESS GREEN 'SUBMIT FORM' BUTTON WHEN COMPLETE. If you do not see a confirmation screen, please scroll up and check that all mandatory fields have been completed and then press SUBMIT again.

The information in this form will be used by TechMarketView and MXC Capital to assist in the selection of applicants to participate in the Little British Battler programme. TechMarketView and MXC Capital may also contact applicant companies to apprise them of their respective services. Information will not be passed to third party organisations without permission from the applicant company. BY SUBMITTING THIS APPLICATION YOU CONFIRM THAT YOUR COMPANY IS PRIVATELY HELD AND IS NOT A SUBSIDIARY OF ANOTHER ORGANISATION.