Application Form

To help ensure that we can gather a diverse range of family experiences, we want to involve families with varying children's ages, ethnic backgrounds, and disabilities and/or additional needs.

Please answer this short survey to help us choose the best combination of families for the focus groups.

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* 1. Your Full Name

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* 2. Your Email Address

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* 3. Your Phone Number : We will only use this if we can't contact you by email.

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* 4. Have you been to the Science and Industry Museum (SIM) before?

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* 5. Please confirm that you can commit to attending two focus group sessions with just parents/carers. (Suitable dates and times can be arranged with SIM.)

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* 6. Please confirm that you can commit to attending two focus group sessions together with your child/ren. (Suitable dates and times can be arranged with SIM.)

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* 7. Please write your and/or your child(ren)'s ethnic background(s) here.

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* 8. Please write your child(ren)'s age(s) here.

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* 9. Please describe your child(ren)'s condition(s) or additional needs.

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* 10. Please confirm that you and/or another responsible adult will remain responsible for your child(ren) during the two family focus group sessions at SIM.

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