Referral Form This form is for sessions in our third term of 2024, Sessions start from 2nd September. Please enable JavaScript in your browser to complete this form.Participant SectionTo be filled out by workshop attendee. All session start week beginning 2nd September 2024Title *Mr, Mrs, Miss, Ms etc.PronounsHe/HimShe/HerThey/ThemName *FirstLastEmailPhone *Date of Birth *day/month/yearAddressAddress Line 1Address Line 2CityState / Province / RegionPostal CodeWhich group would you like to join? (Please select one option only.) *Monday 12pm – 2pm Choir (Castlemilk Community Centre) 2nd SeptemberWednesday 12pm – 2pm Visual Art (Castlemilk Community Centre) 4th SeptemberMonday 12pm – 2pm Crochet Starts 2nd SeptemberMonday 2pm – 4pm Taiko Drumming 2nd SeptemberTuesday 12pm – 2pm Drama 3rd SeptemberWednesday 12pm – 2pm Guitar 4th SeptemberWednesday 2:30pm-4:30pm Choir 4th SeptemberThursday 12pm – 2pm Guitar 5th SeptemberThursday 2:30 – 4:30 Drama 5th SeptemberFriday 12pm – 2pm Visual Art 6th SeptemberFriday 2:30 – 4:30 Creative Writing 6th SeptemberSaturday 12pm – 2pm Visual Art 7th SeptemberSupport NeedsPlease tell us if there is anything you think we should know to help you participate, for example leaving space at the table for wheelchair access, large print or being closer to the tutor to hear better. Referring Agency To be filled out by referrer, if you are self referring please provide emergency contact details.NameFirstLastPhoneEmailRole for instance O.T, CPN, CMHT, Social WorkerDoes the person have a care plan and does this activity contribute towards it?Please describe what outcomes are expected for the participant during their attendance at Nemo ArtsPhoneSubmit