Community Mindfulness Course for refugees and asylum seekers

Wellbeing course for women migrants May 2025 application form

Course dates: 10-week course, 10.00-12.00, on Tuesday mornings, from 6 May to 8 July 2025 in Kemptown, Brighton
To help us support you as best we can, we would be grateful if you would complete the following questions. However, if there are any questions you would prefer not to answer, please leave them blank. We need responses to questions with an asterix/star as shown*. The form will remain confidential to the course organiser and facilitator.

If you have any queries, or you prefer not to fill in this form, please email Lara at spft.smc@nhs.net. Please put "wellbeing course for women migrants" in the 'subject'

Personal details
Application form name
This information is for reference only
Full name*

First NameLast Name
Email (this is required. We ask for your email to help us be in touch and you can be added to our mailing list to receive information and updates)*
example@example.com
Mobile number (this is optional. We ask as it is helpful for us to contact you and will enable us to add you to a WhatsApp group for the course)
Example 07770 123456
The course will be run near Lidl in Kemptown. Will you require a bus pass to get there?*
Address (this is helpful so we can contact you if we are concerned about you and cannot reach you by phone or email. This information is only for the course organisers and will not be shared with anyone else).

Street Address

Street Address Line 2

CityCounty

Post CodeCountry
GP details

This is optional. We only ask for these details in case we are worried about your safety - we would contact you first and only contact your GP if we cannot get in touch with you.
GP/Practice Name
GP Address

Street Address

Street Address Line 2

CityState / Province

Postcode
GP Phone Number
Please enter a valid phone number.
Additional info

Reasons for applying
What do you hope to gain or learn from this course?
This is a 10-week course at 10:00-12:00 on the following Tuesdays: 6, 13, 20 & 27 May, 3, 10, 17 & 24 June, 1 & 8 July. You will benefit most from the course if you can attend all 10 sessions. However, the first four sessions are open to allow you and others to try it first and see if you like it. Please indicate which is most likely:

I would like to attend the early sessions to try it firstI would like to attend all 10 sessions
Additional Optional Info
This wellbeing/mindfulness course does ask people to make gentle movements. These can usually be adapted to meet people’s needs. If you have any physical mobility issues, please provide details below.
Is there anything else it would be helpful for us to know that might affect how you get on in the group? We want you to feel as safe and comfortable as possible on the course, so please let us know if there is anything we can do to help with this.
Should be Empty:

Wellbeing course for women migrants May 2025 application form