Music Healing Veterans Canada Intake Form

Where Words Fail, Music Speaks

Hans Christian Anderson

THANK YOU FOR YOUR INTEREST IN THE MUSIC HEALING VETERANS PROGRAM

Though a little lengthy, please take the time to fill out this form. 

 

Your information will be forwarded to the chapter you indicate is the closest to you, and you will soon be contacted by that chapter with further instructions and information on how to begin your journey.

 

Please note, although we would love to be able to provide instruction to everybody, we do not have the resources, nor are we equipped to do so. Therefore, our focus must remain with those that are dealing with injuries. 

 

PRIVACY: The information you submit is treated as confidential and will never be shared with anybody outside of the Music Healing Veterans board members, or intake representatives.

Are you applying as a
Tell us about Yourself
Aside from our website, we mostly communicate with our members through Facebook. Do you currently have a Facebook Account?
What is your preferred method of contact?
What is your current service status?
What is/was your occupation?
If you selected the 'Other' category please specify your occupation in the field below
Do you live with an Operational Stress Injury (OSI), such as PTSD. etc? (invisible injuries)
Anything at all, no matter how big or small it may seem.
Disability, Arthritis, Diabetes, Epilepsy, Mobility Assistance, etc.
Have you ever previously played an instrument?
Music Healing Veterans Canada focuses primarily on teaching various levels of guitar. What level of guitar would you like to learn?
For those interested in guitar - are you right or left handed?
Do you own the instrument you currently wish to learn?
Do we have your permission to use your picture (taken during meetings and events) for our social media marketing?

RULES:

 

Music Healing Veterans Canada has a ZERO-TOLERANCE policy when it comes to harassment, violence or aggression of any kind. We are here to always provide a safe environment for both students and instructors.

 

Failure to follow the zero-tolerance policy will result in an IMMEDIATE removal from the program.

 

  • Respect each other.
  • Absolutely no drama.
  • No war stories, this program is about healing through music.
  • No foul language. Classes may be held at various facilities (churches, legions, etc.) and we must represent the program, Veterans, First Responders and Medical Professionals in a positive manner.
  • Smoking and the use of alternate medicine is permitted in designated locations only. Place all cigarette butts in the provided receptacles, and please be respectful of any requests of those that run the facility you are using.
  • Please notify your instructor or Chapter Manager if you cannot attend a meeting;
  • If you have a private lesson and you cannot attend, please notify your Instructor and the Program Director as much in advance as possible.
  • Our beginner program offers a loaner instrument system (mainly guitars). If you decide you no longer wish to take part in the program, please return the instrument you have on loan.
  • Have fun!