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Mercury Creatives Application Form
Personal Details
First name
*
Surname
*
Company name (if applicable)
Job title/position
*
Email
*
Phone
*
Website (if applicable)
Address
Address Line 1
Address Line 2
City
County
Postal Code
Afghanistan
Albania
Algeria
American Samoa
Andorra
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Anguilla
Antarctica
Antigua and Barbuda
Argentina
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Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo, Democratic Republic of the
Congo, Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini (Swaziland)
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Korea
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russia
Rwanda
Réunion
Saint Barthélemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia
South Korea
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen Islands
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
US Minor Outlying Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Vietnam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Åland Islands
Country
Business/Practice Details
Are you a registered company?
*
Yes
No
Please provide your company number and date of registration
What type of business are you?
*
Sole trader (self-employed)
Private limited
Pre-start (not currently a registered company)
Partnership
Community interest company (CIC)
Other (please specify)
Please specify your business
Where is your business/practice based?
*
Essex
Suffolk
East Sussex
Kent
Other (please specify)
Please specify where your business/practice is based
More specifically, which town or towns are you based in?
*
What is your business/practice area of specialism?
*
Actor
Advertising and marketing
Architecture (set/carpentry/scenic art)
Arts administration
Choreographer
Circus performer
Comedian
Composer
Crafts (wardrobe/make-up artist/wigs/prop-making/armoury)
Creative practitioner
Dancer
Design (set/sound/lighting)
Digital (film/tv/video/radio/photography)
Director
Dramaturg
Lighting technician
Live arts/visual arts
Musician
Producer
Puppeteer
Pyrotechnics
Singer
Sound technician
Stage management
Stage technician
Writers (composer/poet/script/reviewer)
Prefer to self-describe (let us know below)
Please specify your business/practice area of specialism
Please describe your business/practice
*
What would you consider have been the key barriers to your professional development? (Pre COVID-19)
*
What effect has the COVID-19 pandemic had on your business/practice?
As part of the Mercury's building redevelopment, hireable office space, meeting rooms and other facilities are now available for us by local creatives. How might access to the theatre's new and improved facilities positively impact your business/practice development?
Which 5 attributes do you feel MOST CONFIDENT in?
*
Planning and goal setting
Financial management/book keeping
Developing new products or services
Company governance/HR
Legal matters and intellectual property
Client relationship management
Sales and negotiation
Brand and profile development
Web presence and social media
Marketing and PR
Public speaking and promoting your work/product/service
Outsourcing processes and/or production
Business premises (studio/office/work space etc.)
Funding/fundraising
Organisational structure
Networking
Which 5 attributes do you feel LEAST CONFIDENT in?
*
Planning and goal setting
Financial management/book keeping
Developing new products or services
Company governance/HR
Legal matters and intellectual property
Client relationship management
Sales and negotiation
Brand and profile development
Web presence and social media
Marketing and PR
Public speaking and promoting your work/product/service
Outsourcing processes and/or production
Business premises (studio/office/work space etc.)
Funding/fundraising
Organisational structure
Networking
Has your business/practice previously received any state aid?
*
State aid is financial assistance given by the government or government run bodies to companies or other organisations. (e.g. Arts Council England).
No (I haven’t received any state aid)
Yes (I have received LESS than 200,000 euros in state aid
Yes (I have received MORE than 200,000 euros in state aid
Not yet (I have applied and I am awaiting a decision)
What time of day would be best for you to attend mentoring sessions or programme events?
*
Not all mentoring sessions need to happen in person and can take the form of phone/skype calls
Do you have any access needs we should be aware of?
How did you hear about this opportunity?
*
Social media
Mercury Theatre website
Partner website
Personal recommendation
Poster/roller banner
Newspaper advertisement
Flyer/leaflet
Email/digital flyer
Other (please specify)
Please specify how you heard about this opportunity
Communications consent
Please select the ways we can contact you
*
Email
Phone
Post
Would you like to be contacted by the Mercury Theatre regarding future professional development programmes?
Yes
No
If offered a place, I understand that my contact information will be shared with my allocated mentor
*
Contact details will only be shared if a place is offered on the Mercury Creatives programme.
I understand
If offered a place on Mercury Creatives, I agree to make use of my allocated mentoring time and will seek to attend all business development events
*
I agree
Signature
*
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