Music Creators Export Form

1

Name* This field is required.

First Name

Last Name

2

Email* This field is required.

example@example.com

3

Phone Number

Area Code

Phone Number

4

Are you submitting information on behalf of a music creator ?* This field is required.

Submitting as the music creator

Submitting as the representative of the music creator

5

Please tick the following box to provide BLACMEX consent to process data for administrative and research purposes* This field is required.

Express consent given

7

Is your gender the same as the gender you were assigned at birth?* This field is required.

Yes

No

Prefer not to answer

9

My Nationality is:* This field is required.

Please leave blank if you prefer not to answer.

10

Tell us your current country of residence* This field is required.Scroll and Select

11

Do you have a diasporic connection and if so which country?

Yes

No

12

Your diasporic connection | Tell us which country* This field is required.Scroll and Select

14

Root Genre* This field is required.Scroll and Select

27

Largest venue/location capacity for domestic shows played* This field is required.

100-400

500-1000

1000-3000

4000-10, 000

10, 000+

28

What percentage of these local shows were paid?* This field is required.Scroll and Select

30

Largest venue/location capacity for international shows played* This field is required.

100-400

500-1000

1000-3000

4000-10, 000

10, 000+

31

What percentage of these international shows were paid?* This field is required.Scroll and Select

32

Have you received grant based funding in the last 5 years?* This field is required.

Yes, I have received grant funding

No grant funding received

33

Useful informationPlease provide any useful information or leave blank