Stage Two — Supporting The Unsung Hero

SELECT COURSE DATES

TITLE

EMAIL

AGE

HOW DID YOU HEAR ABOUT THE COURSE?

CONTACT NUMBER - MOBILE

CONTACT NUMBER - HOME/BUSINESS LAND LINE

SERVICE DETAILS: SERVICE NUMBER

SERVICE DETAILS: RANK

SERVICE DETAILS: FULL NAME

SERVICE DETAILS: SERVICE NUMBER

SERVICE DETAILS: CURRENT/LAST SERVING UNIT

YOUR BUSINESS: ARE YOU ALREADY TRADING? IF YES

What is the name and date the business started and the legal status? e.g Ltd, CIC, Sole Trader, Partnership

NO, NOT TRADING

If no, what type of business would you like to start-up and when do you plan to start trading?

CONSENT

TERMS & CONDITIONS

Note 1: I give permission to images/video and audio of me being taken and used for marketing and publicity purposes by the Black Country Chamber of Commerce. By agreeing, I grant the Black Country Chamber of Commerce full rights for the use of the images arising from the photography/ video filming and any reproductions, or adaptations of such, for fundraising, publicity of other purposes to help achieve the University’s aims. This may include, but is not limited to, the right to use them in their printed and online publicity materials, social media, press releases and funding applications. Note 2: I give permission to the Black Country Chamber of Commerce to contact me by email, post, SMS, phone or other electronic means with information which may be of interest to me regarding their products and services: Data Protection: ‍The Black Country Chamber of Commerce are committed to protecting your privacy. Your personal information will be stored securely on a database, and shared with our partner The University Of Wolverhampton. All data will be shared in accordance with the Data Protection Act 1998. We do not transfer information to territories outside of the European Economic Area without adequate levels of protection. For more information of how we use your personal information and the rights available to you, please see our Privacy Notice available here: Black Country Chamber of Commerce www.blackcountrychamber.co.uk/t-cs-and-privacy-policy/ ‍ ‍Opting out: ‍If at any time you would like to be removed from our database, or no longer wish to receive marketing communications, you can do so in a number of ways: • Send an email to sarahwalker@blackcountrychamber.co.uk • Write to us at: Black Country Chamber of Commerce, Creative industries centre, University of Wolverhampton Science Park, Glashier Drive, Wolverhampton.

STAGE TWO APPLICATION FORM

Supporting the Unsung Hero course

👇 Please fill in the wait list form below👇

SUPPORTING THE UNSUNG HERO

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