Music As Medicine Work That Reconnects Workshop Application Form
Thank you for your interest in the Music As Medicine Work that Reconnects Workshops. Your information will be treated confidentially, we are only gathering your personal details for the purpose of your application.
Email address *
What is your full name? *
Your answer
What is your contact number?
Your answer
Which workshop are you applying for? *
What is your gender? *
What is your age group? *
What would you like to get out of the workshop(s)? *
Your answer
Can you tell us a bit about your background in relation to climate & other activism, volunteerism, community work etc.? *
Your answer
If you are applying for the Sunday 28th July workshop for facilitators, can you tell us about your facilitation work?
Your answer
Please tell us about any community or group singing experience you may have had in the past?
Your answer
Would a lack of childcare be a barrier to you participating in this workshop?
Do you have particular needs which would influence your participation? (e.g. learning, mobility, dietary)
Your answer
Which pricing would you chose if you get a place? *
What local/global issues are you most concerned with at the moment?
How do you feel you are coping with 'the state we're in' globally at the moment?
Where did you hear about the workshop?
Your answer
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