Becoming a Role Model

About you

Registering as

Title

First Name

Last Name

Business Name or Intended Business Name

Email Address

Phone Number

Mobile phone number

Street address

Street address line 2

Post town

Postal code

Local authority

Website

Date of Birth

Demographics

Do you speak Welsh?

What is your preferred language?

Are you happy to present in the medium of Welsh?

Do you consider yourself disabled?

We want to show any young people with a disability that if they are interested in entrepreneurship there are role models in similar circumstances who have overcome barriers to become successful business people. We believe in equal opportunities and encourage applications from any potential Role Models with disabilities or accessibility requirements.

Do you have any accessibility requirements?

Gender, do you consider yourself

Please provide further information

Are you black, minority or ethnic origin?

Industry

Background

This content will be used to support your online profile which sits on the Big Ideas Wales website. This helps our partners select the most relevant role model for their workshops/activities and inspires the young people who read about you. Please consider this when providing the requested information. Each field will only allow 300 words, so please don’t exceed this or your application may not submit correctly

Why do you want to be a Big Ideas Wales Role Model?

Briefly talk about your business' product or service

Tell us about your personal journey and background

Briefly describe your business' background

What factors do you think have contributed most to your success, or what top tip would you give?

What position do you hold in your business?

How long has your business been operational?

(in years)

How many employees does your business have?

Is your business VAT registered?

If so, what is your business' VAT number

If you were educated in Wales, please can you complete the following fields:

Name of primary school

Name of secondary school

Name of college/further education institution

Name of university/higher education institution

What stage of business would you be interested in Mentoring?

Start up

1-2 years trading

2-5 years trading

5+ years trading

Reference 1 name

Reference 2 name

Reference 1 number

Reference 2 number

Why are you interested in becoming a mentor?

Please provide your reasons for seeking mentoring support and business background if applicable

Is your business trading?

How long have you been trading

(in years)

Agreement

Privacy Notice Agreement

I agree with the Privacy Notice.

The privacy notice can be found here

Code of Conduct

I agree with the Code of Conduct.

The code of conduct can be found here

Safeguarding

I have read and agree to the Safeguarding Policy

The Safeguarding Policy Statement can be found here.

Vetting checks

I agree to undertake vetting checks

DBS checks

I agree to having DBS checks carried out (this is not a requirement for all activities as a role model)

Training

I am happy to undertake any necessary training