THE LEAP - Game for change
Please fill in the form below to let us know if you want to speak about what you think of your community and what you'd like to improve. If you are chosen for the project once completed we'll reward you with a £10 voucher
(for Just Eat/Morrisons/ASDA etc)
Your name *
Phone number *
Email Address *
Age
Ethnicity
Address (Ideally we are looking for those in or near Manningham, Bradford Moor, Tong, or the City)
We will arrange to record an 15 minute interview over the phone with you, What way can we contact you?
We will call you once this form is submitted, Is they any times that are inconvenient?
How often do you go to "arts" projects?
Never
Once or twice
Often
Sometimes
Plays/Shows
Cinema
Gallery
Painting/Crafts
Dance
Poetry/Story telling
Clear selection
I consent for Impact Gamers to contact me for a short interview, your details and views will be shared with THE LEAP. I understand if there are are many people applying I may not be chosen for an interview, so may not get the voucher and my details will not be used. *
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy