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BBC Dragons' Den Application Form 2013

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BBC Dragons' Den Application Form 2013

  1. 1. You should give as much information as necessary to enable us to assess your business idea but should not disclose any information which is to be treated as commercial in confidence. You must not include details on any application or process which may be patentable unless you have secured the patent or this is pending – if you do disclose this it may invalidate any patent application you later make. DRAGONS’ DEN APPLICATION FORM NAME: Age: Date of Birth: Home: Email: Work: Mobile: Home Address: Company Address (if relevant): Present Occupation: Marital Status: Previous Jobs (please list): BUSINESS Name of business: Describe your idea in one line: Amount of investment required: % share in exchange: Executive summary: In the Executive Summary, you have the chance to sell yourself and your idea, and give a clear and comprehensive outline of your business or product. What problem does your idea solve? What stage are you at with patent or copyright protection? Where are you up to with prototyping or testing? Describe sales, if your business is 1
  2. 2. trading. Please supply any additional information you feel may be useful. Do you have a written business plan? OTHER INFO Have you been on Television before? And have you applied to appear on any other business programmes? (If yes, please give details) Where did you most recently hear about the show? Have you applied to the show before? Please use this section to tell us about yourself. Do you have any criminal convictions? (Please give details whether spent or otherwise). Do you give your permission for the BBC to carry out a full Criminal Record Bureau (CRB) check to verify the above details? Have you ever been bankrupt or been disqualified from being a director of a company? (Please give details). ENTREPRENEUR AVAILIBILITY Recordings take place in Salford. Should you be successful in being selected for the series, you will be required to attend 1 recording day which could be a weekday. (Note: we will do our best to accommodate you, but please be aware that it may not be possible to include you in the series if your availability is limited.) Please indicate any dates that you will definitely not be available for filming: 2
  3. 3. MONITORING The BBC is committed to equal opportunities to all, irrespective of race, colour, creed, ethnic or national origins, gender, marital status, sexuality, disability or age. Note: The BBC will only use your personal details for the purpose of selecting contestants for the Dragons’ Den series. Your information, in particular your ethnic origin and disability data, will also be used for statistical monitoring of Dragons' Den applicants. Your information will be treated in the strictest confidence by the BBC and individual data will not be provided to any other party. For further information, please read the BBC's privacy policy at www.bbc.co.uk/privacy/. ETHNIC ORIGIN ASIAN/ASIAN BRITISH BLACK/BLACK BRITISH CHINESE MIDDLE/NEAR EASTERN MIXED ETHNIC GROUP WHITE BLACK OTHER ____________________ GENDER DISABILITY MALE Do you consider yourself to have a disability? YES FEMALE NO ADVERTISING To help us with our research would you please state where you found out about the application process for Dragons’ Den (please tick as appropriate): TV APPEAL RADIO (Please state name of station) _________________ PRESS ADVERT (Please state publication) ______________ FLYER OR POSTER (Where did you see it?)______________ BBC WEBSITE EMAIL BBC BIG SCREEN ANNOUNCEMENT WORD OF MOUTH OTHER (Please specify)_____________________________ SIGNATURE I confirm that the information given in this form is, to the best of my knowledge and belief, true and accurate. Please sign and print name below. SIGN PRINT 3
  4. 4. We regret that BBC members of staff and their immediate families are not eligible to apply and all applicants must be 18 or over. RETURNS Please return the completed form ASAP by post or email to: EMAIL: dragonsden@bbc.co.uk POST: DRAGONS' DEN 5th FLOOR, BRIDGE HOUSE MEDIACITY UK SALFORD M50 2BH Unfortunately, due to the high number of applicants only those people who are short listed will be contacted. However, we do consider all applications carefully. All information provided is subject to and will be treated in accordance with Data Protection Act 1998 and will not be used for any purpose other than assessing applicants to take part in the named BBC programme. 4

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