Referral Form

Participant Section

To be filled out by workshop attendee
Mr, Mrs, Miss, Ms etc.
day/month/year
Workshop times can be found at theatrenemo.org/whats-on
Theatre Nemo has been funded to supply art supplies and if required lend a tablet with internet data. Theatre Nemo staff are available to help you to use the tablet if needed. We are are also able to lend a guitar when neccesary.

Referring Agency

To be filled out by referrer, if you are self referring this can be left blank
for instance O.T, CPN, CMHT, Social Worker
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