Application for After the Storm

(Please copy into an email and fill in your answers. Email it back to us at playbackcentre@hvi.net)

Name

Contact info

 

PT experience, work

Do you intend to bring a youth representative?

If you are a youth representative, list dob, school or work

Why do you wish to attend?

What are potential trouble spots in your community where pt might be useful

Anything else you wish to tell us?

For scholarship assistance, which is decided on a needs basis, you will need to fill out another form. Please email us for our scholarship application at: playbackcentre@hvi.net