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* 1. Full name

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* 2. Email Address

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* 3. Mobile Number

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* 4. Southwark Postcode (you must be a Southwark resident or business)

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* 5. How old are you?

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* 6. Are you in receipt of any benefits?

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* 7. Do you have a business at the moment? If yes, what do you specialise in?

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* 8. Are you interested in becoming your own boss? If yes, what would you like to do?

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* 9. Will you be attending the morning session 10am - 12.30pm for the talk with our business expert Colin Crooks, CEO? (YES / NO)

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* 10. Option to also attend the afternoon one-to-one session  - please state your preferred time

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