Pre-Start Registration Form
Name
*
First Name
Last Name
Email
*
example@example.com
Number
*
Please enter a valid phone number.
Post Code
*
Post Code
Residential London Borough
*
Please Select
Kensington and Chelsea
Westminster
Hammersmith and Fulham
Wandsworth
If your borough is not listed above please enter it below
About You
*
Please Select
Male
Female
Other
Prefer not to say
Age group
*
Please Select
16 - 24
25 - 29
30 - 34
35 - 39
40 - 44
45 - 49
50 - 54
55 - 59
60 - 64
65+
Prefer not to say
Ethnicity
*
Please Select
Asian or Asian British
Black, Black British, Caribbean or African
Mixed or multiple ethnic groups
White
Other ethnic groups
Prefer not to say
Any other background
Prefer not to say
Do you have a disability, or a health condition as defined in the Disability Discrimination Act 1995? (Physical or mental impairment with ‘substantial long-term’ negative effect on ability to do normal daily activities).
*
No
Yes
Prefer not to say
Are you in receipt of any state benefits e.g Universal credit, housing benefits, Job seekers allowance (We ask because we may be able to refer you to additional support)
*
Yes
No
Business sector
*
Please Select
Shop/Cafe Lending Store Rentals Others, please specify below
Fashion and accessories
Retail
Store
Rentals
Training, tuition and coaching
Sports and fitness
Hair and beauty
Music and entertainment
Healthcare
Food and drink
Other
If you selected other please specify your Business
Business stage
*
Please Select
Idea Stage (have an idea but have not done any research)
Pre-Start (have carried out research but not started)
Do you have a Business name yet? (Please type N/A if not applicable)
*
Explain your business or business idea (Please explain in as much detail as possible)
*
Do you have any experience of running your own business?
*
Yes
No
If you live in the Royal Borough of Kensington & Chelsea, we also require a recent proof of your address (dated in the last six months). We accept electricity / gas bills, a council tax bill, or a bank statement; this is simply to ensure that you are able to benefit from the free appointments available to you as a local resident. Once you have submitted the completed form AND sent us the proof of address, we will get in touch with you to book an initial telephone call – this will be a phone call.
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Do you have an online presence
*
Yes
No
If you already sell online please enter your website or selling platform e.g. Etsy
*
Have you set up any social media accounts for your business? E.g. Instagram, Facebook, TikTok)
*
Have you done any market research?
*
Yes
No
Have you considered any of the following? (Check all that apply)
Who are your target customers?
How will you sell to your target customer?
How often will your customers buy from your?
Who are your most relevant competitors?
None of the above
Have you consider the initial start-up costs for your business
Yes
I have some idea
No, Not really
I have an existing business
Please explain, in as much detail as possible, the advice you need
Have you received any grants or support from any publicly-funded body, e.g. any local, regional or national government or an enterprise agency, within the last 3 years?
Yes
No
If Yes, what was the amount received or estimated value of the support?
Have you accessed PBC resources before or a new client? (e.g NKC event, Courses, Webinars, 1-2-1 sessions)
Returning client
New client
Referred from
Please Select
Social Media
Direct Email
Google, Word of mouth
Job Centre
North Kensington Newsletter
Chamber of Commerce
PBC outreach
Would you give us permission to send you an email from time to time? (We would like to send you valuable updates, such as specific businesss news, upcoming events, webinars, free courses and offers)
*
Please Select
Yes
No
Submit
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