Young Creatives Registration Form (2025)
Identity
First Name
Last Name
Pronouns
Please Select
He/Him
She/Her
Them/They
Which name do you like to be known as?
Date Of Birth
Day
1st
2nd
3rd
4th
5th
6th
7th
8th
9th
10th
11th
12th
13th
14th
15th
16th
17th
18th
19th
20th
21st
22nd
23rd
24th
25th
26th
27th
28th
29th
30th
31st
Month
January
February
March
April
May
June
July
August
September
October
November
December
Year
2035
2034
2033
2032
2031
2030
2029
2028
2027
2026
2025
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
1957
1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
1919
1918
1917
1916
1915
1914
1913
1912
1911
1910
How would you describe your sexual orientation?
Please Select
Heterosexual / Straight
Homosexual (Gay/Lesbian)
Asexual
Bisexual
Queer
Questioning
Pansexual
Prefer not to say
Other
Gender
Please Select
Male
Female
Nonbinary
Genderqueer
Two-Spirit
Prefer not to say
Genderfluid
Agender
Cultural background
Please Select
White British
Scottish
Irish
White Other Background
Black African
Black Caribbean
Black British
White and Black Caribbean
White and Black African
Mixed Race
Black Other Backrgound
White/Asian
Asian British
Bangladeshi
Indian
Chinese
Asian Other Background
Prefer not to say
Address
Address 1
Address 2
Town
Borough
Post Code
Mental Health Services
Are you currently engaged with a mental health service?
Please Select
Yes
No
Prefer not to say
Have you been previously engaged with mental health services?
Please Select
YES
NO
Which borough is/was this service located?
Contact
Email
Mobile
Preferred method of contact
Mobile
Telephone
Email
Emergency Contact
Full Name
Relationship to Participant
Mobile
Email
Content Consent
I give my consent / permission for my artistic content created during Raw Material sessions, to be used if required on the Raw Material social media and website
Please Select
Yes
No
Prefer not to say
Medical/Dietary needs
Do you have any special medical or dietary needs we should know about?
Care Co-ordinator/Key Worker
Care Co-ordinator/Key Worker
Please Select
Yes
No
Prefer not to say
First name
Last name
Contact number
Email address
Support
Do you have any additional requirements in order to participate?
Media Consent
I give my consent / permission for photos and videos to be taken during the project, to be used if required on Raw Materials’ social media and website
Please Select
Yes
No
Prefer not to say
Programme
Please select one Young Creatives activity (aged 16 - 30)
Please Select
Co-Lab
In The Mix
Producer Accelerator
Programming Committee
Studio session (by REFERRAL ONLY )
Young Producers (Weekly Sessions)
Why you are interested in this project?
I can commit to all sessions throughout the term, and understand that if I do not attend, my position will be offered to another member.
Please Select
YES
NO
Was this form completed by a participant or care coordinator?
Please Select
Participant
Care Coordinator
Someone Else
How did you hear about Raw Material?
Submit