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Business Champions Application



Your Details

Please enter a password which you will use to login to Business Champions. The e-mail address you provide will become your username.

Password
Confirm Password

 
 

Indicates an item which is compulsary for your Business Champions application.

Please enter your Name, Gender, Job Title and Organisation

Title
First Name
Last Name
 
 
Gender
Job Title
Organisation

Indicates an item which is compulsary for your Business Champions application.

Please enter your Address details:

Address
Address Line 1
Address Line 2
Address Line 3
Town
County
 
City
Postcode
     

Indicates an item which is compulsary for your Business Champions application.

Please enter your contact details

Telephone
Mobile
Fax

 
Email
Website
   

Indicates an item which is compulsary for your Business Champions application.

Please enter details about your Business or Organisation

No. of employees
Business Sector
Organisation Description

Please upload your CV by pressing select in the box below and locating the file on the on your computer

Upload your cv
 
How did you hear about us?

You are not obliged to answer the following questions, but by doing so you will help us to monitor the profile of Business Champions

Age
Ethnic Origin
Other, using your own definition
 


Your Interests As a Business Champion, where do your interests lie?

Theme Group's:
Type of Activity:


Your Expertise
Provision of expertise: This section is crucial to your registration as a Business Champion. It is the main description of your skills and expertise that we will use to describe you to organisations who have requested help. This will also appear on you online directory entry. Please take a moment to complete this - we suggest about 150 words.



Please indicate your areas of expertise

Skills:
Do you speak any foreign languages?


Please Specify


Sector Experience









  


Additional Information
Please give brief details below of any other outside interests that may help us use your skills and energy in supporting the regional agenda, or any other comments you may wish to make.