Name

Position

Organisation/Group

Address

Phone

Email

Website

Postcode

Have you heard of The Media Workshop?

YES

NO

If yes, how did you first hear about us?

Internet

Media Workshop staff

Email

Leaflet

Something in the press

Word of mouth

Other

Are you planning any projects in the next three years?

YES

NO

If yes, can you please tell us what these might be?

Would your group benefit from any of the following training?

Leaflet/annual report design

Website design

Powerpoint presentations

Digital Photography

Exhibition/display panel design

YES

NO

Are there any particular services that you would like us to provide (this could be particular training courses or anything that would benefit your group that you don’t see on the list of things we already offer)?

Does your group attend events or exhibitions?

Do you have your own display material?

What local and national publications to you read that are relevant to your work?  

Has your group ever considered using a black and white darkroom for projects?

YES

NO

YES

NO

What is the focus of your group/organisation?

How many people are involved/supported by the work you do?

Would you like us to contact you to tell you more about the services we could offer you?

YES

NO

Would you like to be added to our mailing list?

Become a Group Member (FREE)?

YES

NO

YES

NO