Designer Fashion Fund Application Form

* required field(s)

Company Information

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• Brand Name*
• Company Name (if different to brand name)
• Ltd Company or Sole Trader?*
  --select-- Ltd Sole Trade
• Address 1*
• Address 2*
• Address 3
• Postcode*
• Country*
• Telephone Number*
• Fax Number
• Email (generic)*
• Website
• Product Category (womenswear, menswear, ready to wear, accessories)*
• Length of time in business*
• Current organisational structure Including employees and roles, consultants, outside advisors and professional organisations that you are currently working with.*
• Company Ownership*

Designer Information

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• First Name*
• Surname*
• Gender
  Male Female
• Email*
• Direct Telephone*
• Mobile Number*
• Design Training*

Second Designer ------- (if applicable)
• First Name
• Surname
• Gender
  Male Female
• Direct Telephone
• Mobile Number
• Design Training

Finance Information (£)

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• Annual Turnover 08/09*
• Profit 08/09*
• Annual Turnover 09/10*
• Profit 09/10*
• Annual Turnover 10/11*
• Profit 10/11*
• Projected Turnover 11/12*
• Projected Profit 11/12*
• Projected Turnover 12/13*
• Projected Profit 12/13*

Manufacturing

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• Type of manufacturing*
• Details of Manufacturer*
• Manufacturing Quality Referee (Current Stockist)*
• Name*
• Job Title*
• Telephone Number*
• Relationship*

Stockists

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• UK Stockists*
• International Stockists*

Referees

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• Name*
• Company*
• Job Title*
• Telephone Number*
• Relationship*
• Name*
• Company*
• Job Title*
• Telephone Number*
• Relationship*
• Name*
• Job Title*
• Company*
• Telephone Number*
• Relationship*

Fund Application

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• Please outline how you would spend the money?*
• Your Ideal Mentors / Areas of Mentoring you would like to receive*

Diversity Monitoring
• Ethnicity*
  --select-- White - British White - Irish Other white background MIxed - white & black Caribbean Mixed - white & black African Mixed - white & Asian Asian / Asian British - Bangladeshi Any other Asian / Asian British background Black / black British - Caribbean Black / black British - African Any other black / black British background Chinese Any other ethnic group Any other mixed background Prefer not to say

Disability
• Under the definition in the 1995 Disability Discrimination Act*, do you consider yourself disabled?*
  --select-- Yes No Prefer not to say

*The Disability Discrimination Act 1995 defines disability as ‘a physical or mental impairment which has a substantial and long-term adverse effect on the ability to carry out day to day activities’. This can include physical impairment (including asthma, diabetes, epilepsy etc), mental health issues, learning difficulties, dyslexia, hearing impairment, visual impairment (not corrected by glasses) and progressive conditions (e.g. cancer, multiple sclerosis, muscular dystrophy, HIV).
• Applicant Acknowledgement ------ By ticking this box I agree to have read and understood the terms of entry, guidance notes and Applicant Acknowledgement*