Harmonia Sanctuary

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Harmonia Sanctuary

First Name *

Last Name *

E-Mail Address *

Preferred Nickname

Street Address *

City *

State

Country *

Social Media Profiles- Facebook, Instagram

Postal Code

Mobile Number *

Will you have your mobile phone on during the festival? *

Yes

Gender *

Age *

Ethnicity

Occupation *

How do you spend most of your time?

Languages Spoken

Please indicate level of fluency for each language listed: basic / competent / fluent.

General Professional Experience

Do you have any relevant work experience (for example, medical, therapeutic, counseling, harm reduction)?

Prerequisites pt. 1 *

Please check the following criteria that are true statements regarding your prior experience.

I have had previous experience as a care giver in psychedelic crisis situations.

I have had professional experience in a psychiatric ward (as a doctor, nurse, or similar).

I have had personal experience with psychedelic substances.

I have a professional background in healthcare services.

I possess therapeutic and/or massage skills.

I have an interest (academic, professional, or personal) in psychedelic science.

I am linked to a harm-reduction organization.

I have had prior experience volunteering/working (in any capacity) at a music festival or similar event.

I have been recommended by a previous member of this care service.

Required

Prerequisites pt. 2

Tell us why you want to be involved in Harmonia.

Certifications (not required)

Please check the following up-to-date certifications you possess.

First Aid

CPR

Harm Reduction

Crisis Intervention

Crowd Management (offered free online in most states)

Other:

In what capacity would you like to be involved with Harmonia? *

Space Holder/ Care Giver (Festivals, requires basic certifications)

Build and Deco Crew (Festivals)

Event staff-Fundraisers and non-festival events produced by Harmonia

Educator / workshop facilitator

Other:

Required

Explain why you'd like to work with Harmonia. *

Explain what being a "care giver" means to you. What do you understand to be the basic guiding principles in such work? *

Describe a few times in which you have helped someone through a difficult emotional experience (psychological, interpersonal, etc.) and how you handled the situation. *

Is there anything else you would like us to know?

Submit

Clear form

Never submit passwords through Google Forms.

Forms

This content is neither created nor endorsed by Google.