Company Name*
 
 
 
 
 
 
 
Is the company trading?*
 
Yes
No
 
 
 
 
 
 
Main Contact First Name*
 
 
 
 
Main Contact Last Name*
 
 
 
 
Phone Number*
 
 
 
 
Email Address*
 
 
 
 
Confirm Email Address*
 
 
 
 
 
 
 
Address Line 1*
 
 
 
 
Address Line 2
 
 
 
 
City
 
 
 
 
County*
 
 
 
 
Post Code*
 
 
 
 
Company Website
 
 
 
 
 
 
 
Preferred Language for communication*
 
English
Welsh
 
 
 
 
 
 
Please provide an overview\Description of the business (Max 1000 characters)*
 
 
 
 
Please provide details of the support required in order to grow the business (Max 1000 characters)*
 
 
 
 
 
 
 
 
How did you hear about Social Business Wales?*
 
 
 
 
Word of Mouth/Other:
 
 
 
 
 
 
 
 
 
 
 
We take data protection very seriously and process data in compliance with the General Data Protection Regulations.
 
 
 
We will only process your data in order to deliver the services you’ve requested from us, report to our funders and evaluate our effectiveness. Once you have submitted this form we will email you a copy of our privacy notice, or you can read it [here].  
 
 
 
Please tell us if we can also contact you for the purposes outlined below:
 
 
 
Can the Wales Co-operative Centre contact you by post, telephone, email or text in order to tell you about other Wales Co-operative Centre activities that may be of interest to you?
 
 
 
Contact from Wales Co-operative Centre?*
 
Yes
No
 
 
 
 
 
 
Can we share your details with other similar organisations so they can send you information by post, telephone, email or text, which may be of interest to you?
 
 
 
Share with 3rd Party Organisations?*
 
Yes
No
 
 
 
 
 
 
We may be able to get you additional support from Business Wales; can we share this form with colleagues from Business Wales and ask them to contact you?
 
 
 
Contact from Business Wales?*
 
Yes
No