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Striking A Notable Difference In Healthcare Since 2002
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Harp Therapy
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Certified Master Harp Therapist/ Certified Master Therapeutic Musician Program
Bedside Harp@Home Program
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Resources
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Videos
Practicum Projects
Special Moments
Honor
Harp String References
Certified Graduates
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About
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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
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
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British Indian Ocean Territory
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Bulgaria
Burkina Faso
Burundi
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Cameroon
Canada
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
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Congo, Democratic Republic of the
Cook Islands
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Dominican Republic
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El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini
Ethiopia
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Finland
France
French Guiana
French Polynesia
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Gambia
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Ghana
Gibraltar
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Greenland
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Guyana
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Maldives
Mali
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Mayotte
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Namibia
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Netherlands
New Caledonia
New Zealand
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Niger
Nigeria
Niue
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North Macedonia
Northern Mariana Islands
Norway
Oman
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Palau
Palestine, State of
Panama
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Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russian Federation
Rwanda
Réunion
Saint Barthélemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin
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Saint Vincent and the Grenadines
Samoa
San Marino
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Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Sudan
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Sudan
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Sweden
Switzerland
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Taiwan
Tajikistan
Tanzania, the United Republic of
Thailand
Timor-Leste
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Tonga
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Tuvalu
Türkiye
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Uganda
Ukraine
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United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Viet Nam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Åland Islands
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
Name
This field is for validation purposes and should be left unchanged.
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