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About You

Full Name *

Address *

Postcode & City *

Phone Number *

Email Address *

Your Home & Workspace

Which municipality do you live in?

Do you have a dedicated room or workspace that could be used for assembling mobiles? *

Yes No Not yet

Is your workspace smoke-free and pet-free? *

Yes No

Your Experience

Have you worked with crafts, assembly work or other detailed handwork before? Tell us a little about your experience.

What do you do today? (Optional)

Health

General health *

Normal Not normal

Are your shoulders and arms in good health and free from problems? *

Yes No

Getting to Know You

What interests you about becoming part of our homeworking tradition?

What do you enjoy about working with your hands?

Do you have any family members or acquaintances among our current home-based workers? Feel free to tell us who.

Availability

Approximately how many hours would you be able to dedicate to assembling mobiles? *

Less than 5 hours per week 5–10 hours per week 10–20 hours per week More than 20 hours per week It depends

Would you primarily be assembling mobiles... *

On my own Together with my partner Together with another family member Other

Marital status *

Single Married Living with a partner Other

Age(s) of any children living at home

Do you currently have another job? *

Yes No

Do you receive a pension, benefits or similar financial support? *

Yes No

Are there any times of the year (apart from summer holidays, Christmas, etc.) when you would not be available for home-based work?

Anything Else?

Is there anything else you would like us to know?

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