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First name
Last name
Date of Birth
Address 1
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Address 2
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Work Telephone
Mobile Telephone
Company address
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Previous jobs (please list)
Name of proposed business
Descibe your idea in one sentence
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Investment amount
% Share in exchange
Please provide an 'Executive Summary'. 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 trading. Please supply any additional information you feel may be useful. Please keep to a maximum of 300 words
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Do you have a business plan?
Have you been on TV before, including any business programmes? (If yes, please provide details)
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How did you hear about the show?
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Have you applied for the show before?
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Please use this area to tell us a bit more about yourself
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Do you have any criminal convictions? (Please give details whether spent or otherwise)
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Do you give permission for the BBC to carry out a full Criminal Record Bureau (CRB) check to verify these details?
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Have you ever been bankrupt or been disqualified from being a director of a company? (If yes, please give details)
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To help with our research; where did you find out about the application process for Dragons' Den?
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Do you confirm that the information in this form is, to the best of your knowledge and belief, true and accurate?

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. Unfortunately, due to the high number of applicants, only those people who are shortlisted will be contacted. However, we do consider all applications carefully. All information provided is subject to and will be treated in accordance with the Data Protection Act 1998, and will not be used for any purpose other than assessing applicants to take part in the named BBC programme. We regret that BBC members of staff and their immediate families are not eligible to apply. All applicants must be aged 18 or over.