Contact Name:
Business Name:
Address:
Postcode:
Phone:
Mobile:
Email:
Website:
Trading status:
Date Business Established:
Description of main business activities, including products/services:
No. of Employees:
No. of Locations:
Business Sector:
Annual Turnover:	If not available please estimate.
Export Sales ROI £:
Export Sales GB £:
Export Sales Other £:
Specialist Assistance (Tick up to 2 options.):	Business Planning Marketing & Sales Market Research Finance Legal IT Process & Systems Import/Export Innovation Other
Please give specific detail on the issue within your business you wish to address and the type of support you are seeking:
Please outline all other supports which your business is currently receiving, eg: business support programmes, grant support, mentoring etc.:
I Consent:	I understand that the personal data that I submit will be required to process my request. I understand that this data will only be used for the purposes of the request and will be held in accordance with current data protection legislation.
I Consent:	We would like to add you to our business directory to enable us to contact you from time to time with details of other Economic Development programmes and events.
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