Refractions Participant Questionnaire
Thank you for taking interest in Blindspot Collective's Refractions.

Refractions: A Collection of Human Anthems is an opportunity for those who are grieving during this period of physical distancing to collaborate with artists and create original music inspired by the individual who was lost. Of the many heartbreaks this pandemic has caused, the inability for friends and families to gather and grieve the loss of loved ones is tragic and devastating. Whether the result of coronavirus or other causes and regardless of culture or faith, our means of celebrating and remembering those who have died has been disrupted. As grief becomes a persistent presence in many of our lives, we are left to process the loss in isolation.

With Refractions, bereaved volunteer participants are invited to have a conversation with an artist from Blindspot Collective who has been trained in sensitive conversation practices, to share about the life of a loved one who has passed. The artist will then collaborate with a songwriter or composer to do our best to develop an original piece of music inspired by the memories of that individual, and a recording of the music will be made to celebrate their life.

Our goal is to create 15 complete original songs, but we are working on ways to service everyone.

Please fill out this form and a member from our team will reach out to you shortly.
Sign in to Google to save your progress. Learn more
Your Name *
What is the name of the individual you wish to be remembered and celebrated as part of this project? *
What is your relationship to them?
In a few sentences, tell us why you're interested in this project.
Your Email Address *
Do you prefer to be contacted through email or another way? *
What are some dates and times you are available for a conversation next week? *
Any other questions or information you'd like to share with us?
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Blindspot Collective. Report Abuse