We have a new website!
If you are not re-directed there automatically, please click here
DATABASE FORM
The Birmingham Centre for Arts Therapies is currently updating its mailing list, if you or your organisation would like to be included on our database please print out the form and mail it to us at the address on the main page.
| Name: | ||||||||||||||||||||||||||||||
| Name
of Organisation: |
Position/Status |
|||||||||||||||||||||||||||||
| Date: | ||||||||||||||||||||||||||||||
| Address: Post Code: |
||||||||||||||||||||||||||||||
| Phone No: | Fax No: | |||||||||||||||||||||||||||||
| Web Site Address: | ||||||||||||||||||||||||||||||
| E-Mail Address: | ||||||||||||||||||||||||||||||
| Type of Organisation/Profession: | ||||||||||||||||||||||||||||||
| Parent | Carer | Teacher | Student | Media | Charities | |||||||||||||||||||||||||
| Psychologist/Psychotherapist | Doctor/Psychiatrist | Prison/Probation Service | ||||||||||||||||||||||||||||
| Further Education | Social Worker | Therapist | Other | |||||||||||||||||||||||||||
| Category/Ages | 0-11 | 12-19 | 20-30 | 31-60 | 60+ | |||||||||||||||||||||||||
| Area of Interest | Art | Dance | Drama | Music | All | |||||||||||||||||||||||||
Notes/Requests
for Further Information:
|
||||||||||||||||||||||||||||||