CRTV CLNC: Application Form
Welcome to The Clinic. We are looking forward to sharing our expertise and helping you on your creative journey.

Our courses will be running from the end of November until March 2021.

We want to make sure you get the most out of our workshops and panel discussion/wellbeing sessions, so please fill out this short application form so we can tailor our classes accordingly.

Once you've applied, you will receive a private Zoom link to your course. If you've not received the email three days prior to the course date, please check your spam/junk folder. Any issues, please email us at

By filling out this form, you will be automatically included in our CRTV CLNC newsletter which will have updates to our upcoming courses, resources, news from our partners and offers. You can unsubscribe any time.
Email address *
Untitled Title
Full Name *
Home Address (including your Post Code) *
Phone Number *
Age *
Gender *
Emergency Contact Details (Please include the person's name, phone number, email address and your relationship to that person (e.g. Brother, Sister etc)) *
Occupation Status *
Do you have any previous experience working in the creative industry? This could include productions for film or TV. *
If your previous answer was yes, please state below
Do you consider yourself to have a disability? *
By "disability", we mean any physical or mental impairment which has a substantial and long-term adverse effect on a person's ability to carry out normal day-to-day activities
If your previous answer was yes, please state below
Do you have any accessibility needs? *
By "accessibility", we mean any barriers which could effect you from completing the course
If your previous answer was yes, please state below
Which of the following course(s) do you wish to sign up for? Tick all that apply. *
You will also be automatically enrolled in the panel discussion and wellbeing session which will follow on from your workshop
What are you hoping to gain from the course? This will help us to tailor your experience *
Would you like to be added to our mailing list to be the first to find out about our upcoming events and courses? *
Never submit passwords through Google Forms.
This form was created inside of RENAISSANCE STUDIOS.