Voice Squad Online Sign-Up

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All questions relate to the participant. If you are completing the form on behalf of someone else, please provide your name in Q2

Email *

1. Name of participant *

2. If completing on behalf of the participant please provide your name

3. Contact Telephone

4. Age Group *

5. Ethnicity

White

Mixed/Multiple ethnic Groups

Asian/Asian British

Black/African/Caribbean/Black British

Other Ethnic Group

If you answered 'any other' in the Ethnicity section above and would like to describe your ethnicity in further detail please do so here

Are you living with any form of neurological condition, for example Dementia?

Yes

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Our videos are split into three categories which you can choose from depending on your taste and situation. You can choose to receive one or all three or you can leave it up to us to decide which will suit you best, based on the information you have provided.

Popular and upbeat songs from the 60’s and 70’s

Golden oldies and silver screen classics from the 40’s and 50’s

Specialised sessions for those living with Dementia including well known classics from the music hall and wartime eras as well as popular songs from stage and screen

Please choose for me

Thank You

Thank you for signing up to the Voice Squad Online. Videos are sent out to participants on a weekly basis via email. Queries should be directed to voicesquad@armonico.org.uk or 01926 800109

A copy of your responses will be emailed to the address you provided.

Submit

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