The Ruined Theatre - 2023 Creative Access Mentorship Course
July - August 2023
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Email *
Name *
Phone number *
Address *
Date of Birth *
Ethnicity *
Do you consider yourself to have a disability or any additional needs? *
If yes, please provide any information that will enable us to support *
Emergency Contact Name *
Emergency Contact Phone Number *
I confirm that I am available on the given dates specified in the Course Outline (please use 'Other' box to state when you are not available) *
Which menteeship Pathway are you interested in?
Clear selection
What would you like to achieve out of undertaking the Creative Access Mentorship Scheme? (100 words max)
If you have selected the FOCUSED PATHWAY which focus area are you interested in?
Do you have an up to date DBS? (This is not a requirement.)
Clear selection
Thank you
All information will be kept confidential and dealt with sensitively.
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