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DADAA
EXPRESSION OF INTEREST FOR NEW CLIENTS
Today’s dateName of person wanting to enrol
Address
Date of Birth
Phone Number
Mobile Number
Describe any of your past experiences in the arts?
Which of DADAA’s hubs would you like to attend? tick/cross/circle your preference
Fremantle / Midland / Lancelin / Other/Regional
Which art form are you interested in? tick/cross/circle your preference
Visual / Digital / Dance
Performance / Music / Other?
Have you identified a specific program or workshop that you would like to enrol in?
To view our programs and workshops, go to www.dadaa.org.au
write or type here..
Would type of arts course would you choose? tick/cross/circle your preference
Introductory / Developmental / Advanced
DADAA workshops provide a welcoming and supportive creative space for artists with a lived experience of disability and/or mental illness, or social or economic disadvantage. Do you identify with any of these? / Yes / No
Are you of Aboriginal or Torres Strait Islander descent? / Yes / No
Is your first spoken language English? / Yes / No
DADAA’s programs have a fee structure. Do you have access to funding? / Yes / No
If so, what funding do you access that you would like to use at DADAA?
If no funding, do you want support to see what funding may be available to you? / Yes / No
Are you filling out this form for: / Yourself? / Someone else?
If for someone else, what is your relationship to the other person?
If for someone else, who is the legal guardian with decision-making authority for the person?
If you have an advocate who is not a family member, who you would like present to help you with decision-making, please provide details. We will only contact the person with your permission.
Name:
Contact details:
Organisation if applicable:
______
Email completed form to: or send to: 21 Beach St, Fremantle WA 6010