JUNIOR DRAGONS’ DEN APPLICATION FORM
You should give as much information as necessary to enable us to assess your business idea but should not
disclose any information which is to be treated as commercially sensitive and confidential. You must not
include details on any application or process which may be patentable unless you have secured the patent
or this is pending – if you do disclose this it may invalidate any patent application you later make.
A maximum of 2 people can be involved in the application process for Junior Dragons Den and a maximum
of 2 people can represent the pitch in the Den if selected.
Your application will not be considered without Parent/Guardian signature(s).
To be eligible to apply to Juniors Dragons Den you must be at least 12 years of age at the time of applying
and not have your 18th birthday falling prior to 1st March 2014 i.e. anyone who will reach 18 years of age
prior to 1st March 2014 is not be eligible for Junior Dragons Den.
Applicant name:
Age:
Home Address:
Date of Birth:
Email:
Tel home:
Mobile:
Parent/ Guardian name
1:
Mobile Number of
Parent/ Guardian 1
Nationality
Secondary school Name
and address:
Parent/Guardian name
2:
Mobile Number of
Parent/ Guardian 2
Applicant name 2 (if
applicable)
Age:
Home Address:
Date of Birth:
Email:
Tel home:
Mobile:
Parent/ Guardian name
1:
Mobile Number of
Parent/ Guardian 1
Nationality
Secondary school
Name and address:
Mobile Number of
Parent/ Guardian 2
Mobile no
Parent/ Guardian 2
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BUSINESS
Name of business idea:
Describe your idea in one
line:
Executive Summary:
In this section of the form you have the chance to tell us about yourself and
your idea.
Why did you come up
with this idea?
What problem does your
idea solve?
Give a clear and
comprehensive outline
of your business.
What stage are you at
with patent, copyright &
trademark protection?
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Where are you up to
with prototyping or
testing?
OTHER INFO
Have you appeared on television before?
(If yes, please give details)
Where did you most recently hear about
Junior Dragons’ Den?
Please use this section to tell us about
yourself.
ENTREPRENEUR AVAILABILITY
Applicants will be shortlisted from application forms. Shortlisted applicants will be required to meet the
producers before a final decision is made on who will appear in the Den.
You will be advised on what this meeting involves should you reach the next stage of the selection process.
All television recordings will take place in Dublin. Should you be selected for the series, you will be required
to attend 2 recording days. These days could be weekdays.
If selected the producers may require signed confirmation from the applicant’s school confirming permission
that the applicant may take part during school term.
Please outline any dates that you are not available for filming in February and March 2014:
___________________________________________________________
NB: we will do our best to accommodate you, but please be aware that it may not be possible to include you in
the series if your availability is limited.
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MONITORING
Screentime ShinAwiL is committed to equal opportunities to all, irrespective of race, colour, creed, ethnic
or national origins, gender, marital status, sexuality, disability or age.
Note: Screentime ShinAwiL will only use your personal details for the purpose of selecting contestants for the
Dragons’ Den series. Your information will also be used for statistical monitoring of Dragons’ Den applicants.
Your information will be treated in the strictest confidence by Screentime ShinAwiL and individual data will
not be provided to any other party.
GENDER
DISABILITY
Do you consider yourself to have a disability?


MALE
FEMALE
TO BE SIGNED BY PARENTS/GUARDIANS


YES
NO
The person(s) appearing in the recording is a minor (under the age of 18), We/I confirm that We/I am the
parent(s) or guardian(s) of the minor child and I consent to his/her contribution to the Series and the
recordings thereof. We/I sign this letter in the capacity of being the parent or guardian of the minor child and
that the below statements relating to ourselves / myself also apply to such minor child.
I confirm that the information given in this form is, to the best of my knowledge and belief, true and accurate.
Please sign and print name below.
Please note that an employee or contractor of Screentime ShinAwiL or RTÉ or Bank of Ireland or of the
Dragons or the presenter of the series or a close relation (i.e. a father, mother, sister, brother, guardian,
wife, husband, partner) of a Screentime ShinAwiL/RTÉ/Bank of Ireland/Dragon employee or contractor or
of the presenter of the Series are not eligible to apply and you undertake to make immediate and full
disclosure to Screentime ShinAwil of any other pre-existing connection you may have with any of the
Dragons or the presenter of the Series. You also confirm that your child is under 18 years old and you
acknowledge that you may be required to provide proof of age and identity. By signing below you also
confirm that the minor is entitled to present this business proposal as part of the series without having to
obtain the permission or consent of any third party. You acknowledge that other persons may submit
proposals which have similar or coincidental elements to yours and that Screentime ShinAwil/RTÉ and Bank
of Ireland are under no obligation whatsoever to you or the Minor if we choose one of those proposals
instead of this one. You agree to waive any claim you or the minor might have against us and to release us
from any obligation to you or the minor in respect of any such other business proposal as may be
submitted to us which are similar to or have coincidental elements in them with this proposal whether
used in the series or otherwise. By signing below, you also consent to the use of personal data of the minor
provided in this form by Screentime ShinAwil for the purpose of selecting contestants for the Dragons’ Den
series and for statistical monitoring of Dragons’ Den applicants.
SIGNATURE OF APPLICANT 1:
NAME PARENT/GUARDIAN 1 (BLOCK CAPS):
SIGNATURE
NAME PARENT/GUARDIAN 2 (BLOCK CAPS):
SIGNATURE
SIGNATURE OF APPLICANT 2 (IF APPLICABLE)
NAME PARENT/GUARDIAN 1 (BLOCK CAPS):
SIGNATURE
NAME PARENT/GUARDIAN 2 (BLOCK CAPS):
SIGNATURE
Do you give your explicit permission for the Screentime ShinAwiL to carry out a full background check to
verify the above details?
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RETURNS
Please return the completed form preferably by email (scanned) or by post to:
EMAIL: [email protected]
POST:
DRAGONS’ DEN
SCREENTIME SHINAWIL
83 – 87 RANELAGH VILLAGE
DUBLIN 6
Unfortunately, due to the high number of applicants only those people who are short listed will be
contacted. However, we do consider all applications carefully.
Screentime ShinAwiL is committed to equal opportunities to all, irrespective of race, colour, creed, ethnic
or national origins, gender, marital status, sexuality, disability or age.
Note: Screentime ShinAwiL will only use your personal details for the purpose of selecting contestants for the
Dragons’ Den series. Your information will also be used for statistical monitoring of Dragons' Den applicants.
Your information will be treated in the strictest confidence by Screentime ShinAwiL and individual data will
not be provided to any other party.
All information provided is subject to and will be treated in accordance with Data Protection Acts 1988 and
2003 and will not be used for any purpose other than the purposes described above.
Disclaimer: Bank of Ireland shall not be liable for any consequence of act(s) and/or omission(s) of any third
party or service provider.
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