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* 1. Please enter your name

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* 2. Your address

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* 3. Contact phone number

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* 4. Contact email address

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* 5. Tell us a bit about your business/idea

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* 6. What type of support do you need?

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* 7. Do you want want to be part of the Lockleaze Business Network?

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* 8. Consent. I agree to share my data with Buzz and for them to hold this data on their secure database

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* 9. I agree for Buzz to contact me with information on training opportunities, networking events and business support. Please tick how you would like to be contacted

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* 10. Would you like to receive the monthly Buzz newsletter? It contains updates from Buzz and local events/training opportunities

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