Capita Scaling Partner Digital Disruptor Application Form - CM/CX

TIPP logoCapita logoThank you for your interest in becoming a Capita Scaling Partner Digital Disruptor for Customer Management/Customer ExperienceThis is the second initiative in the TechMarketView Innovation Partner Programme series.

In order to be considered, you must first apply to attend a Pre-Qualification Session (PQS) by completing this application form as fully as possible and submitting it by Friday 2nd November 2018. We will advise you if your application has been successful within two weeks of the close date. The PQS will be held in London in early December.

After we receive your application, we may ask you to submit your company sales/corporate/investor deck to assist our evaluation.

To be eligible, you should be the founder or CEO/MD of a privately-held UK tech company with an innovative digital technology proposition in Customer Management/Customer Experience that has the potential of disrupting established markets or creating new markets. Your proposition must (i) be at or close to the MVP (minimum viable product) stage: (ii) have been successfully deployed to one or more clients; and (iii) now be ready for distribution at scale.

There is no fee required to apply for or participate in the Capita Scaling Partner Digital Disruptor Pre-Qualification Session.

You can find further information about the event on the TechMarketView website and about the Capita Scaling Partner programme on the Capita website.

For any further information please contact tipp@techmarketview.com.

For the purposes of GDPR, details of our privacy poilcy can be found here.

 

 

 
 
COMPANY INFORMATION

Company name *
(As registered at Companies House)
 

Company Number *
(As registered at Companies House)
 

HQ phone number *
 

Website address *
 

LinkedIn page
 

Year founded *
 

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

Primary revenue source *
(Select from the drop-down list the primary source of your company's revenues)
 

Primary revenue source (explanation)
(Please add any explanation if needed)
 

Number of employees *
(How many people currently work for your company and how many of them are freelance contractors? )
 

Company control *
(Which of the following options best describes ownership of you company?)
 

Company control (explanation)
(Please add any explanation if needed)
 

Funding status *
(Please advise on funding to date, when and how much funding will be required at next round)
 

 
 
MARKET FOCUS

Proposition focus *
(Please indicate which of the following capabilities best categorises your technology or proposition (tick all that apply))
 






Proposition focus (Explanation)
(If you ticked Other in the prior question please explain here)
 

Sector focus *
(Please tick your current active sectors.)
 














Sector focus (Explanation)
(Please add any further explanation of your previous answer if you need.)
 

Fastest growing sector *
(Which of these is your FASTEST GROWING sector?)
 

Geographical focus *
(Please tick your current active geographies)
 





Geographical focus (explanation)
(Please add any explanation if needed)
 

Fastest growing geographical region *
(Which is your FASTEST GROWING geographical region?)
 

 
 
PARTNERSHIP POTENTIAL

Revenue run rate *
(What is your CURRENT annualised headline revenue run-rate?)
 

Projected annual revenues in 2021 *
(What is your forecast for your annual revenues in 2021?)
 

Projected EBITDA in 2021 *
(What is your forecast for your annual EBITDA in 2021?)
 

Projected TCV & length in 2021 *
(What do you think the total contract value (TCV) and contract length will be for a new client you sign up in 2021?)
 

Largest client *
(Who is your largest client and what is the current revenue run rate you derive from them?)
 

Intellectual property *
(What proportion of your revenues do you consider to be attributable to your own intellectual property (IP). )
 

Obstacles to growth *
(What are the main obstacles to doubling your revenues in the next 12-24 months (please select up to THREE)? )
 














Other
(If Other, please explain)
 

Ambition *
(Why do you think Capita should partner with your company?)
 

 
 
RESPONDENT INFORMATION

First name *
 

Surname *
 

Position/Title *
(Please note that this application should only be completed by the company Founder or CEO/MD.)
 

Contact phone number *
 

Contact email address *
 

Source *
(How did you hear about the Capita Scaling Partner Digital Disruptor event?)
 

Source (Other)
(Please advise how you heard about the Capita Scaling Partner Digital Disruptor Event if not from one of the sources above.)
 

 
 
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The information in this form will be used by authorised TechMarketView and Capita personnel with a specific need to know to assist in the selection of applicants to participate in the Capita Scaling Partner Digital Disruptor Event. TechMarketView and Capita may also contact applicant companies to apprise them of their respective products and services. Information will not be passed to other third party organisations without permission from the applicant company.