Full Name (required)

Job Title (required)

Business Name:

Business type: (Choose which options are relevant)
Beauty SalonNail SalonSelf-employed therapist Renting a roomWorking from homeMobile TherapistNail Therapist Makeup TherapistComplementary Therapist Limited Company
Note: You can select more than one option using keyboard key Ctrl and select option

Full Address:(required)

Email (required)

Telephone/Mobile Number:(required)

Description about your company - max 50 words (required):

Enter your company address website:

Enter your company Twitter handle (if you have one, e.g. @LGFFUK):

Enter your Facebook profile link (if you have one, e.g. www.facebook.com/LGFFUK):

Enter your Instagram handle (if you have one, e.g. @LGFFUK):

Enter your Linkedin page or your profile link:

Total number of employees taking part:

Total number in your team:

Brands used within your business:

Do you have or have previously had a Criminal Record Bureau check.
 Yes No

Where did you hear about us?
OnlineWord of MouthSocial MediaOther

How Flexible are you?:
---flexibleAvailable at short noticeWeekdays amweekdays pm

What would your preferred involvement be: (select a minimum of one before):
How many hours are you happy to commit for the three weeks throughout January?

What would your preferred involvement be: (Select one or more):

Beauty Services in the Community
You have the option to attend any care service provider and perform treatments in-house on selected individuals, a timesheet list of individuals will be provided to the therapist on the day from a list of treatments the therapist has agreed to perform. We recommend a minimum of 2-3 hours a week over 3 weeks in January, this time however is at the discretion of the therapist.
 YES NO

Beauty Treatment Vouchers for Individuals and their families
Throughout December 2016 participating salon/therapists will give out vouchers to company partners who will then hand them out to those in need and their families to come and visit the salon throughout the month of January!
 YES NO

Beauty Salon Event (SALONS ONLY)
Invitations are given to your selected Care Service Provider who will invite individuals in need and their families to a one-off event in January, where they will receive free pampering and anything else you wish to provide.
 YES NO

What treatments would you prefer to offer? (e.g. massage, facials, nails, pedicures, hand massage, foot massage, makeup):

If you have any other requirements or would like to provide additional information, please add it below:

Please upload your Company logo:

Please upload your proof of Liability Insurance:

Please upload your proof of Qualifications:

Optional: Please upload an image of yourself or your team and why you want to join the campaign

I have read and agree to the terms and conditions
 Yes No

By submitting this application you are consenting you have answered the questions to the best of your knowledge and belief, and agree to our terms and conditions below