*
First Name
Last Name
Residential Address
*
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Email address
*
Contact phone number
(###)
###
####
Date of birth (dd/mm/yy)
MM
DD
YYYY
2. In addition to XR event - Production Park. which of the following courses would you also like to attend? Please note that this is subject to eligibility and availability. Select all that apply.
3. Which of the following best describes what you are currently doing?
*
• Employed full-time (including apprenticeships) – work 35 or more hours per week for an employer
• Employed part-time (including apprenticeships) – work fewer than 35 hours per week for an employer
• Self-employed - run your own business or practice, for example as a sole trader, partnership or director
• Freelancer - you provide services to various clients or companies on a project-by-project basis, without a long-term contract
• Unemployed - you are not currently engaged in paid work and are actively seeking employment
• In education or training - enrolled in an educational institution or training programme
• Working in a voluntary, unpaid role or internship - you are contributing your time and skills to an organisation without receiving financial compensation
• Not in or looking for paid work - for example looking after children or relatives
• Other - please specify
If you selected other above, please specify
4. If you are currently in education or training, please tell us the name of the course you are completing.
Registered business/organisation street address
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Company registration number (if known)
What was the approximate annual turnover of the business/organisation for the last financial year?
No turnover to report
Less than £10,000
£10,000 to £24,999
£25,000 - £49,999
£50,000 - £99,999
£100,000 - £149,999
£150,000 - £199,999
£200,000 - £249,999
£250,000 - £499,999
£500,000-£1m
More than £1m
Don’t know
Prefer not to say
7. Which of the following most closely describes your main occupation? occupation
Advertising/marketing
Architect
Archivist/curator/librarian
Artist
Augmented/virtual reality producer/developer
Crafts/making
Creative/cultural educator
Designer
Fashion designer/maker
Festivals/live events production
Film/television/video production/postproduction
Games developer/ games publisher
Journalist
Musician
Music production/promotion
Performer/Choreographer (e.g. circus, dance, theatre)
Photographer
Publisher
Radio production/ podcasting
Social media content creator
Software developer/publisher
Writer
Not applicable
Other
If you selected other above, please specify.
8. Which of the following most closely describes the main sector that you work in?
Creative Service
Creative Content
Creative Original
Creative Experience
Creative Digital
If you selected other above, please specify
9. How long have you worked in the creative industries?
Never worked in the creative industries
Under 2 years
2 to 5 years
5 to 15 years
15 to 25 years
25 to 35 years
Over 35 years
10. Are you part of any of the below creative networks? Select all that apply.
If you selected other above, please specify
11. What are you seeking to achieve from participating in the programme? Select all that apply.
If you selected other above, please specify
12. Please specify any specific barriers you currently face to achieving your objectives. Select all that apply
If you have any current skills challenges please specify
If you selected other above, please specify
13. How did you hear about the programme?
Email
Word of Mouth
Website
Google
LinkedIn
X (formerly Twitter)
A Fifth Sector employee
Press release
Via a Network - please specify below
Other - please specify below
If you selected via a network, please specify which network
If you selected other, please specify.
14. What is your ethnic group?
Asian or Asian British
Black, Black British, Caribbean or African
Mixed or multiple ethnic groups
White
Other ethnic group
If you have selected other above, please specify
15. Please identify your gender
16. Do you have any physical or mental health conditions or illnesses lasting or expected to last 12 months or more?
Yes
No
Prefer not to say
17. If yes do any of your conditions or illnesses reduce your ability to carry out day-to-day activities?
Yes, a lot
Yes, a little
Not at all
Prefer not to say
20. If Yes, what is the name of the course you completed?
21. This programme is funded by West Yorkshire Combined Authority, would you be happy to be contacted by them or evaluators (Wavehill) to have a further discussion to assist with their research?
Yes
No
