(Allegato 1)

Modulo di partecipazione
BANDO DI SELEZIONE PER FAVORIRE E PROMUOVERE MICRO IMPRESE LOCALIZZATE NELLE ZONE UMIDE

1.	Descrizione dell’idea di impresa 
(caratteristiche dell’attività imprenditoriale) ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
________________________________________________________________________  2. Descrizione della compagine societaria : caratteristiche e ruoli dei soci (da compilare solo per le società, anche quelle costituende) 
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3. Mercato di riferimento
Descrivere il mercato di riferimento geografico; i potenziali clienti; i canali commerciali.
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4.  Entità e qualità degli investimenti. Spese di gestione nel primo anno. Processo      produttivo.
Descrivere:
•	il piano degli investimenti, suddiviso per macrovoci;
•	il piano delle spese di gestione relative al primo anno di attività;
•	l’eventuale processo produttivo (se trattasi di attività manifatturiera).
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5. Modello organizzativo gestionale. (Descrivere l’organizzazione aziendale)

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6. Eventuali ricadute dell’iniziativa sul territorio 

Descrivere le eventuali ricadute dell’iniziativa imprenditoriale sul territorio salentino in termini economici (integrazione di filiere produttive locali, creazione di un indotto stabile e qualificato, incremento della competitività del tessuto produttivo, ecc.) e sociali e di tutela ambientale (miglioramento della qualità della vita dei cittadini, valorizzazione del patrimonio naturalistico e culturale, ecc.)?

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7. Redditività economica della iniziativa imprenditoriale proposta

Descrivere le previsioni economiche relative ai primi due anni di attività ( Piano dei ricavi e dei costi)
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8. Copertura finanziaria degli investimenti

Descrivere i fabbisogni finanziari e le relative coperture finanziarie (Piano degli impieghi e delle fonti)
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9. Eventuale integrazione Orizzontale (Geografica) dell’iniziativa proposta.

Descrivere modalità, tempi e risultati attesi, dell’integrazione che l’iniziativa proposta realizzerà  tra 3 o più aree umide tra quelle interessate al progetto AM.JO.WE.L.S.

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9.bis Integrazione Orizzontale (Geografica) dell’iniziativa proposta:Quadro di Sintesi

Indicare, per le attività proposte, mediante contrassegno, le aree umide interessate dall’iniziativa, secondo lo schema riportato.

ATTIVITA’ PREVISTA/AREA UMIDA INTERESSATA	Laguna di Butrint
(ALBANIA)	Laguna di Rushkull
(ALBANIA)	Laguna di Patok
(ALBANIA)	
	PREVALENTE (SEDE)	SECONDARIA	PREVALENTE (SEDE)	SECONDARIA	PREVALENTE (SEDE)	SECONDARIA	

ATTIVITA’ 1:							

ATTIVITA’ 2:							

ATTIVITA’ 3:							

ATTIVITA’ 4:							

ATTIVITA’ 5:							

ATTIVITA’ 6:							

ATTIVITA’ 7:							

ATTIVITA’ 8:							

ATTIVITA’ 9:							

ATTIVITA’ 10: