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.
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Email *
What is your full name? *
What is your contact number?
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)? *
Can you tell us a bit about your background in relation to climate & other activism, volunteerism, community work etc.? *
If you are applying for the Sunday 28th July workshop for facilitators, can you tell us about your facilitation work?
Please tell us about any community or group singing experience you may have had in the past?
Would a lack of childcare be a barrier to you participating in this workshop?
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Do you have particular needs which would influence your participation? (e.g. learning, mobility, dietary)
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?
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Where did you hear about the workshop?
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