General Membership Basic InformationName(Required) First Last Preferred pronouns(Required)he/himshe/herthey/themEmail(Required) Phone NumberDo you live in Lewisham(Required) Yes No Please provide post code(Required) ZIP / Postal Code Do you work regularly in Lewisham(Required) Yes No Please provide name/s of organisation where you workYour job titlePlease provide post code of your workplace(Required)What is your area of practice?(Required) Painting Sculpture / 3D Print making Photography Graphic Design Fashion / Textile Design Film / TV/ Video Intractive Media and Games Music Dance Poetry / Spoken Word Theatre / Drama Literature / Creative Writing Combined Arts Audio/Radio Other How would you describe your current role(Required) Workshop/activity delivery Creative producer Consultant Researcher Other Would you be interested in receiving information about provision for young people with Special Educational Needs and Disability?YesNoMarketing & CommunicationsHow did you hear about LEAN?(Required)Search engineInstagramLinkedInWords of mouthCross promotion by other organisationsAre happy for your details to be shared with organisations and individuals that work with LEAN?(Required) Yes No Normal communications will be in emails. If you have any access needs, please let us knowYour social media handlesPlease specify the platforms.Diversity MonitoringWe would be grateful if you could complete these questions. We are regularly asked for this information by funders. It will remain anonymous and will help us in to provide more low-cost services for freelancers.What is your ethnicity? Asian/Asian British: Indian Asian/Asian British: Pakistani Asian/Asian British: Bangladeshi Asian/Asian British: Chinese Asian/Asian British: Any other Asian background Black/Black British: African Black/Black British: Caribbean Black/Black British: Any other Black background Arab Latin American White: British White: Gypsy, Roma or Irish Traveller White: Irish White: Any other White background Prefer not to say Not known Other What is your gender? Male Female Non-binary Prefer not to answer Do you identify as LGBTQI+? Yes No Prefer not to say Do you identify as a deaf and/or disabled person, or have a long-term health condition? Yes No Prefer not to say Do you identify as neurodivergent? Being Neurodivergent could include Dyslexia, ADHD etc. Yes No Prefer not to say Consent(Required) I consent LEAN to holding and sharing information provided.Add GDPR information holding statement
