Connect! event submission form 2016

1. Intro & contact details

Please use this form to tell us your event idea with your chosen Connect! artist. The deadline for submissions is 5pm on Friday 18th March 2016. Before filling in the form, if you haven't read any Connect! background information please download our 7 page resource pack which explains the project, the questions we'll be asking in this form and how to answer them fully. Please note: you CAN return to an uncompleted form but only from the same device you started from and only AFTER you have completed, moved on from a page and clicked Next.

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* 1. What is your name?

First Name

Surname

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* 2. What is your email address?

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* 3. What is your phone number?

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* 4. What is the name of your venue?

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* 5. What is your venue's website address?

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* 6. Name and contact details of person responsible for the event (if different from above)

Name

Email address

Phone number

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* 7. Your venue address

Venue Address

Street Adress

Address Line 2

City

Post Code

Country

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* 8. Event address (if different from the above)

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14% of survey complete.