* 1. What is your age?

* 2. Which of these best describes your disability?

* 3. How can we best support you to take part in the course? For example: large print, support workers

* 4. Please rank the days that would best suit you to take part in the course

* 5. Which time of the day would suit you best?

* 6. How long (in hours) would suit you to attend the course?

* 7. How long would suit you to attend the course?

* 8. Which aspect of media interests you most?

* 9. How did you hear about the DMA media training?

* 10. How will you pay for the course?

* 11. Address

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