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Striking A Notable Difference In Healthcare Since 2002
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Harp Therapy
Harp Therapy Certification
Therapeutic Musician Intensive
Teacher Training Certification
Instructional Programs
Mindfulness
Certified Master Harp Therapist/ Certified Master Therapeutic Musician Program
Bedside Harp@Home Program
Shop
Resources
News
Videos
Practicum Projects
Special Moments
Honor
Harp String References
Certified Graduates
FAQ
About
Contact
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Bedside Harp@Home Program Application
1
Program Information
2
Personal Information
3
Musical Background
4
Experience & Training
Program Info
Please indicate when you would like to start this program
If you know at this time which teacher you would like, please indicate
Edie Elkan
Morine Stewart
Lauri Craig
Not Sure
Personal Info
Legal Name
*
First
Middle
Last
Name You Would Like To Be Called
Address (No PO Box Allowed)
*
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
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Belgium
Belize
Benin
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Bhutan
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Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
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British Indian Ocean Territory
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Burundi
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Cook Islands
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Nigeria
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Northern Mariana Islands
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Panama
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Poland
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Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
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Samoa
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Senegal
Serbia
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Somalia
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South Sudan
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Sudan
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Taiwan
Tajikistan
Tanzania, the United Republic of
Thailand
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Uruguay
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Vanuatu
Venezuela
Viet Nam
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Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
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Country
Phone
*
Email
*
Best way to contact you if there is a cancellation:
*
Phone Call
Text Message
Email
Musical Background
If you have no musical background, please skip to question #4 at the bottom.
1. Do you read music? Which clef(s)?
2. What musical instruments do/did you play and what is/was your level of proficiency on each?
Do you presently own a harp(s)? If so, what kind?
3. What is the nature of your musical training and experience?
Please select all that apply:
Do you improvise?
Do you play by ear?
Do you write your own arrangements?
Do you write your own music?
Do you currently take harp lessons?
Do you teach music?
Do you perform?
With whom have you studied / are you currently studying?
At this time do you envision yourself playing for health care once you become proficient on the harp? If you wish to comment further please do so below.
4. Do you sing? What are your favorite songs to sing?
5. What is your favorite kind of music to listen to?
Education/Work Experience
Education: Please include high school, vocational school, college, graduate school.
Work: Please summarize your professional/work experience:
Where did you first hear of our program?
Please mark all that apply:
Mailing
Internet
Facebook
LinkedIn
Instagram
Harp Therapy Journal
Somerset Harp Festival
Referral
Other
If other, please specify:
Additional Comments
Additional Comments
Phone
This field is for validation purposes and should be left unchanged.
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