City Champions

Company name:

Address:

Post Code:

Tel:

Fax:

Email:

Website:

Total number of employees:

Chief Executive/Managing Director:

Name of HR Manager:

Name of Marketing Manager:

1. Which of the following sectors best describes your company?

Manufacturing Industries
Banking or Finance
Construction
Import / Export
Biotechnology
Broadcasting or Media

Professional Services
Retail
Service Industry
Transport
Maritime Industry
Wholesale

Other (please state below)

2. Do you have a corporate social responsibility policy?

Yes
No

3. Why are you interested in becoming a City Champion? (Please select one or more of the following)

Networking
Representation
Public Policy Support or Influence
Information

Involvement In:
City Image
Southampton Port-City Futures
Marketing & PR
Conference / Events
Supporting Southampton City Region

Other (please state below)

4. I would like to be kept informed about Sea City events and activities

Yes
No

5. I am interested in promoting my business through Integrated Media / Marketing Opportunities for our company.

Yes
No

The details provided will occasionally be circulated to other City Champions. However, if you do not wish this information to be made available please tick this box.

6. I agree to the annual payment of £3000 + VAT to become a City Champion.

Name:

Date:

7. Nominated contact within our company / organisation for City Champions.

As Above

Other (please state below)