Company Name*
Company Address Line 1*
Company Address Line 2
Company Town*
Company County*
Company Post Code*
Contact First Name*
Contact Last Name*
Phone Number*
Email Address*
Preferred Language for communication*
Support Enquiry (max 1000 characters)*
How did you hear about Digital Communities 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?*
Allow communication from WCC
DO NOT Allow communication from WCC
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?*