Hello from Rich Mix! Please fill out this form before attending Our Journeys Storytent programme in Spring 2023. The information you provide here is important for us to reach audiences and communicate with funders so that we can continue to offer as many activities as possible. Rich Mix will store and process your data as per our Privacy Policy, which can be found online at richmix.org.uk/privacy-policy. By giving your consent you are also consenting to us sharing relevant data with project partners Tower Hamlets Local History Library & Archives, Teresa Hare Duke and Jakia Khanom.

Name:
Address:
The name of the school your child / children attends, and their year group:
Name of School:
Year Group:
 
Your age:
Do you have any SEND or access needs?
Are you a Tower Hamlets resident?
Do you consent to sharing photographs of yourself participating in the programme?
Would you like to be added to our mailing list?

About You

How do you describe your religion or belief?
How do you describe your gender?

Please choose one of the following options to describe your ethnicity.

Black, Black British or African
Asian or Asian British
White or White British
Mixed or dual heritage
Additional Options

Thank you for filling in this form.