North East Peer Networking Programme - Expression of Interest Form

Throughout this form a * indicates a required field.

A: Your details

A1. Name

A2. Your pronouns?

Examples include she/her, he/them, they/them, etc.

A3. What is your position in the business?

A4. Email address

A5. Business Name

A6. Business Address

A7. Business Post Code

A8. Local Authority Area

A9. Company / Charity Registration Number or UTR

A10. SIC Code

(https://www.gov.uk/government/publications/standard-industrial-classification-of-economic-activities-sic)

A11. Business registration Date (month/year)

A12. Contact Number

A13. Business Overview: Describe the trading/commercial activities of the business. Describe the social aim. What problem does your business solve or need does it fulfil? What social impact does the business have?

A14. Please select which workshop(s) you would like to attend:

Mon 3rd Feb: Workshop 1 - Online 10am - 1pm Mon 10th Feb: Workshop 2 - Online 10am – 1pm Mon 24th Feb: Workshop 3 – Online 10am - 1pm

A15. We want our programme to be as accessible as possible.

If you feel you would require reasonable adjustments prior or in order to participate in an SSE programme due to a disability, caring responsibilities or any other reason, please give details below or contact us by phone or email to discuss further.

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