Mercury Creatives Application Form - Mercury Theatre Colchester

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 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?*

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?*

Which 5 attributes do you feel LEAST CONFIDENT in?*

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*

Please type your full name

Date*