Waiting List - Intake Form
Hello and welcome! Whether you are new on our waiting list or have been waiting for the opportunity to join us for a while, we are so happy to be getting in touch with you. This year Opening Doors is opening some new spaces in our groups and we are also updating our waiting list to learn more about the people who wish to join us. Please answer the following with the person interested in join Opening Doors and feel free to get in touch if anything is not clear. We will be in touch with you with opportunities to join us soon. With thanks, the Opening Doors Team.
Member’s Details:
Name
First Name
Last Name
Contact Number
Date of Birth
Email
example@example.com
Address
Street Address
Street Address Line 2
City
/
Postal / Zip Code
Primary Caregiver Details:
Name
First Name
Last Name
Contact Number
Email
example@example.com
Relation
For example: Mother / Father
Is there anyone else you would like us to keep informed about Opening Doors sessions, performances and events?
Emergency Contact Person:
Name
First Name
Last Name
Contact Number
Relation
For example: Mother / Father
Email
example@example.com
Questions about the Member:
Do you have any condition/s that we should be aware of? And if so, what would you like us to know about the way it affects you and how we can support you?
Do you have any medical conditions that we should be aware of? And if so, what would you like us to know about the way it affects you and how we can support you?
Do you have any physical access or mobility needs?
Is there any other information about your access or support needs that is important for us to know?
What is the best way for us to communicate with you? (Maltese, English, Written, Visual, Spoken, Other).
What is your preferred way of communicating with us? (Maltese, English, Written, Visual, Spoken, Other).
About the Member and Opening Doors:
What Artistic Discipline are you interested in:
Music
Dance
Theatre
Ballet
Tell us about why you want to join Opening Doors?
Do you have past experiences with any of the arts or with Opening Doors?
Send us a short video (less than 1 minute) showing us your talents in action:
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Are you able to attend the sessions by yourself?
No, someone will be dropping me off and picking me up
Yes, I am able to arrive and leave on my own
Other
Attendance is very important to us. It impacts the member’s ability to progress in their artistic discipline, it helps the group to focus and build work together, it helps the teacher to deliver the session they planned.
I am able to commit to attending a weekly session
I commit to being available when we have rehearsals and performances
I cannot make these commitments.
Some final questions:
Would you like to sign up to our newsletter to receive information about Opening Doors?
Yes, please
No, thank you
Would you like to receive emails about third party opportunities (example: performances, workshops, etc…)
Yes, please
No, thank you
How did you hear about Opening Doors?
Is there anything else you would like us to know?
Submit
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